Browsing by Subject "Kidney Function Tests"

Besides regulating erythropoiesis, erythropoietin (Epo) promotes angiogenesis. Circulating Epo concentration does not change during the normal menstrual cycle, yet there are reports of cyclic Epo production in the uterine endometrium of mice. Angiogenetic growth factors similarly mediate the generation of blood vessels in follicles. In Vitro Fertilization (IVF) aims for the maturation of multiple follicles with controlled ovarian hyperstimulation. The most serious complication of IVF is uncontrolled ovarian hyperstimulation syndrome (OHSS). The aim of the study was to investigate circulating Epo in uncomplicated IVF and OHSS. Kidney function and the contribution of anemia, hemoconcentration and –dilution to serum Epo were considered. Repeated blood samples were collected in the IVF group (n=27) and in the OHSS-group (n=47). Epo, cystatin C, creatinine and blood count were quantitated from the samples. A follicular fluid sample was collected in the IVF-group. There was an elevation in serum Epo from natural to stimulated cycle luteal phase in uncomplicated IVF, p=0.003. Human chorionic gonadotropin (hCG) did not correlate with Epo. There was a decrease in serum Epo towards the end of the luteal phase that persisted until follow-up in cycles resulting in pregnancy (p=0.028). hCG-negative women had an increase in serum Epo at follow-up (p=0.028). Follicle fluid Epo concentration was 1.5 times that in serum (p=0.006). During OHSS, serum Epo-level did not change. It correlated negatively with blood hemoglobin in the beginning of study period. There was no difference in serum Epo between uncomplicated IVF and early OHSS. Epo concentration was higher in early rather than late OHSS towards the end of the study period (p=0.016 and 0.008). In late OHSS, serum Epo negatively correlated with cystatin C and serum creatinine on admission (p=0.05 and 0.008). Kidney function tests of the OHSS patients were within normal limits. The results indicate there are changes in circulating Epo in stimulated, unlike the normal, menstrual cycle. Changes were within physiological limits. Further analysis is needed to evaluate the effect of pregnancy and progesterone on Epo. Clinical parameters such as urine output should be considered together with laboratory measures for the estimation of kidney function in OHSS.