Effects of controlled ovarian stimulation on vascular barrier and endothelial glycocalyx a pilot study

Controlled ovarian stimulation significantly amplifies the number of maturing and ovulated follicles as well as ovarian steroid production. Ovarian hyperstimulation syndrome increases capillary permeability and fluid extravasation. Vascular integrity intensely is regulated by an endothelial glycocalyx (EGX) and we have shown that ovulatory cycles are associated with shedding of EGX components. This study investigates if controlled ovarian stimulation impacts on the integrity of the endothelial glycocalyx as this might explain key features of the ovarian hyperstimulation syndrome.

Methods Serum levels of endothelial glycocalyx components of infertility patients (n=18) undergoing controlled ovarian stimulation were compared to a control group of healthy women with regular ovulatory cycles (n=17).

Results Patients during luteal phases of controlled ovarian stimulation cycles as compared to normal ovulatory cycles showed significantly increased Syndecan-1 serum concentrations (10.8ng/ml 5.8^25th-14.5^75th to 13.8ng/ml 9.0^25th-27.1^75th; p=0.026), indicating shedding and degradation of the EGX.

Conclusions To our knowledge, this is the first study indicating shedding of EGX components during ovarian stimulation. Our study suggests that ovarian stimulation may affect the integrity of the endothelial surface layer and increasing vascular permeability. This could explain key features of the ovarian hyperstimulation syndrome and provide new ways of prevention and treatment of this serious condition of assisted reproduction.

Interessenkonflikt

Nina Rogenhofer: Honorare für Vortrags- und Schulungstätigkeiten: MSD Sharp und Dohme, Ferring, Dr. Kade Basins GmbH, Theramex; Finanzielle Zuwendungen (Drittmittel) für Forschungsvorhaben: MSD: Drittmittelzuwendungen, Dr. Kade Basins GmbH; This study was supported by a PI grant from the German Research Society (DFG), MA-6288/1-1 to Arseni Alle anderen Autoren haben erklärt, dass kein Interessenkonflikt besteht.

Publication History

Article published online:
07 October 2020