Objective: To investigate whether vascular endothelial growth factor(VEGF)and pigment epithelial derived factor (PEDF) involve in ovarian hyperstimulation syndrome (OHSS) after controlled ovarian hyperstimulation( COH).rnMethods: Seventy one women received controlled ovarian hyperstimulation (COH) for in vitro fertilization-embryo transfer (IVF-ET) were enrolled this prospective study. Among them, 13 patients developed moderate to severe OHSS,and 30 and 28 patients were high and normal responders respectively. Enzyme-linked immunosorbent assay(ELISA)was used for detecting VEGF and PEDF levels in serum and follicular fluid on the oocyte retrieval day.rnResults: The OHSS patients had significantly higher levels of VEGF in follicular fluid than the high and normal responders (P < 0. 05) . The PEDF levels in follicular fluid in the OHSS patients were significantly lower than those in the high and normal responder group (P<0. 05). The VEGF levels in follicular fluid were positively correlated with E2 levels in serum on HCG day, and negatively correlatedrnwith PEDF in follicular fluid(r=0. 391 ,P<0. 01 ,r= -0. 280,P<0. 05,respectively).rnConclusions: The VEGF and PEDF levels in follicular fluid are associated with OHSS after COH. A balance between PEDF and VEGF may be crucial for the development of OHSS. A cut-off ratio of VEGF/ PEDF in follicular fluid for predicting OHSS development is 2. 60 with 76. 9% of sensitivity and a 79. 3% of specificity.%目的 通过对卵泡液中血管内皮生长因子(VEGF)和色素上皮衍生因子(PEDF)水平的测定,探讨二者与体外受精-胚胎移植(IVF-ET)周期中卵巢过度刺激综合征(OHSS)的关系及其对OHSS的预测价值. 方法 本研究为单中心的前瞻性病例对照研究.71例IVF-ET患者在接受控制性超排卵(COH)过程中呈OHSS高危者43例,其中发生中重度OHSS的13例为OHSS组,未发生OHSS的30例为高危组；同期在COH中卵巢反应正常的28例患者为对照组.采用酶联免疫吸附法分别检测三组患者取卵日卵泡液中VEGF和PEDF水平. 结果 (1)OHSS组的卵泡液VEGF水平明显高于高危组和对照组(P＜0.05),高危组和对照组间比较无显著性差异(P＞0.05).(2)OHSS组的卵泡液PEDF水平明显低于高危组和对照组(P＜0.05),高危组和对照组间比较无显著性差异(P＞0.05).(3)卵泡液VEGF水平与注射人绒毛膜促性腺激素(HCG)日血清雌激素水平呈正相关(r=0.391,P＜0.01),与卵泡液PEDF水平呈负相关(r=一0.280,P＜0.05). 结论 卵泡液中VEGF和PEDF与OHSS的发病密切相关,局部VEGF和PEDF的失衡可能在OHSS的发病中起一定作用.卵泡液VEGF/PEDF的升高可用于预测OHSS的发生.
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