Infertility Clinical Trial
Official title:
Vascular Cell Activation Throughout Ovarian Hyperstimulation for In Vitro Fertilisation: Role of Cell-Derived Microparticles in the Adverse Outcomes
Introduction: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic phenomenon, poorly
understood and difficult to predict, complicating intense ovarian stimulation cycle. The
most severe symptoms, which associate vascular permeability disorders and
hypercoagulability, occur in 0.2 to 1% of the cases and often require intensive care.
Activation of endothelial, platelet, erythrocyte or leukocyte cells trigger the release of
small specific vesicles, called microparticles, used as markers.
Classically leading to endothelial dysfunction and hypercoagulability, the endothelial
activation phenomenon could constitute the main cause of OHSS or help predict its severity,
as established for various other diseases (cerebral stroke, infarct and lupus…). However, so
far, this endothelial activation role has never been studied.
Objectives:
Evaluate the serum level of microparticles as a predictor of adverse outcomes; correlate it
to hypercoagulability and changes of endothelial permeability associated with this syndrome.
Methodology: Prospective Pilote Cohort study, evaluating before and throughout the ovarian
stimulation cycle (6 samples/patient), the serum modulation of:
- Endothelial activation markers (endothelial-derived microparticles, E-selectin)
- Procoagulant markers (microparticles from platelet, erythrocyte or leukocyte origin,
Von Willbrand factor, thrombin-antithrombin complex, prothrombin fragment 1+2)
- Endothelial disjunction marker (soluble CD 146) A group of 50 patients will be assessed
Techniques: Flow cytometry for measurement of microparticles expressing non specific
(Annexin V) and cell specific surface determinants (CD 31, CD 41, CD 45 or glycophorin
A). Use of commercial kits for other serum markers.
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