The impact of a gonadotropin-releasing hormone antagonist on the vascular endothelial growth factor in PCOS patients who underwent in vitro fertilization

Objective:To investigate the impact of gonadotropin releasing hormone antagonist on the outcome and the levels of vascular endothelial growth factor in serum and follicular fluid of PCOS patients who underwent in vitro fertilization.Methods:PCOS patients who subjected to IVF between April 2006 and July 2006 were divided randomly into two groups:the study group:eighteen patients with PCOS were subjected to a multiple-dose protocol of gonadotropin-releasing hormone antagonist.The control group:twenty-four patient with PCOS were subjected to a long protocol of gonadotropin-releasing hormone agonist.The plasm and follicular fluid was pooled for each patient on day of aspirating follicle.The quantitation method of enzyme-linked immunoabsorbent assay(ELISA)was used to measure the levels of VEGF in serum and follicular fluid.To record the dosage of gonadotrophins(HMG and/or rFSH),the duration of administration,the number of retrieval oocyte,fertilization rates,cleavage rates,the levels of serum E2 on day of HCG administration,cycle cancellation rates,implantation rates,pregnancy and the incidence of OHSS.Results:The two groups were similar with respect to the dosage of gonadotrophins(HMG and/or rFSH),the duration of administration,the number of oocyte retrieval,fertilization rates,cleavage rates,The levels of VEGF in serum and follicular fluid,and the incidence of OHSS.Significant differences(P0.05)were found regarding pregnancy,implantation rates and the levels of serum E2 by analyzing statistically(Student's t-test and χ2-test).Conclusion:We demonstrated that GnRH antagonist administration in PCOS patients undergoing IVF did not alter the follicular fluid levels of VEGF,probably,the development of follicle and the oocyte competence.The pregnancy and implantation rates were higher,most likely,Owing to the lower levels of serum E2,which made the incidence of OHSS decrease.These results demonstrated the high-performance and safety of this drug on controlled ovarian stimulation protocol.