Elevated levels of interleukin-6 in the follicular fluid at the time of oocyte retrieval for in vitro fertilization may predict the development of early-form ovarian hyperstimulation syndrome

Objective: To determine the possible predictive role of interleukin-2 (IL-2), IL-6, and tumor necrosis factor (TNF-alpha) in the development of early-form ovarian hyperstimulation syndrome (OHSS). Design: Nested, case-control study. Setting: An IVF unit, university-based program. Patient(s): Follicular fluid (FF) was obtained from 322 high responders. The study group and control group comprised 10 patients who developed early, severe OHSS and 10 who did not develop OHSS, respectively. An additional control group included 10 low-responder patients who did not develop OHSS. Intervention(s): Ovulation induction with hMG combined with GnRH analogue. Main Outcome Measure(s): All FF samples were tested for IL-2, IL-6, and TNF-alpha. The patient's serum was tested for mean E-2 and P concentrations. Result(s): Interleukin-g levels in the FF were significantly higher in the OHSS group than in the two control groups, whereas no differences were found in IL-2 and TNF-alpha. No correlation was found between the FF concentrations of IL-2, IL-6, and TNF-alpha and the mean serum E-2 levels or the number of oocytes retrieved. Conclusion(s): Elevated levels of IL-6 in the preovulatory FF at the time of oocyte retrieval for IVF may predict the development of early-form OHSS in high responders. (C) 1997 by American Society for Reproductive Medicine.