[Association between renin activity, angiotensin II and ovarian hyperstimulation syndrome].

OBJECTIVE: To investigate the association between renin-like activity (RA) and angiotensin II (A II) and the ovarian hyperstimulation syndrome (OHSS). METHODS: Blood samples were taken from 42 patients undergoing in vitro fertilization (IVF). According to the ovarian stimulating response, the patients were divided into 4 groups: group I, low responders, 7 cases; group II, moderate responders, 8 cases; group III a high responders without using albumin, 7 cases, group III b, high responders with albumin, 10 cases; group IV, severe and moderate OHSS, 10 cases. 5 patients for intrauterin insemination with natural cycle as control. Follicular fluid (FF) was collected at oocyte retrieval from 28 IVF patients (including 7 OHSS patients). Fluid from ascites and hydrothorax was obtained from 3 OHSS patients, and peritoneal fluid obtained from 5 infertility patients by laparoscopy and ascitic fluid obtained from 6 ovarian carcinoma patients served as control. RA and A II levels were measured by radioimmunoassay. RESULTS: Plasma RA and A II levels at mid-luteal phase from OHSS patients [(19.9 +/- 19.0) micrograms.L-1.h-1 and (397.0 +/- 378.2) ng/L] were significantly higher than those from the other patients (P < 0.01-0.05), also the levels at mid-luteal phase from IVF patients were significantly higher than those at late-follicular phase [(4.1 +/- 2.9)-(4.9 +/- 3.2) micrograms.L-1.h-1 Vs (1.5 +/- 0.9)-(1.9 +/- 1.0) micrograms.L-1.h-1, (85.5 +/- 49.5)-(109.4 +/- 46.0) ng/L Vs (33.6 +/- 15.9)-(37.0 +/- 17.1) ng/L, P < 0.01-0.05]. RA and A II levels in FF were significant higher than those in plasma (P < 0.01-0.05). A II in ascitic fluid in OHSS patients was 4 to 8 times higher than that in plasma, while RA in ascitic fluid was 1.5 to 3 times higher than that in plasma, but the levels of A II and RA in controls were very low. The plasma RA and A II levels dropped very significantly along with clinical improvement (P < 0.01). CONCLUSION: These findings suggest that RA and A II are associated with the pathogenesis of capillary leakage in OHSS.