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The Pathophysiology of Ovarian Hyperstimulation Syndrome (OHSS)

A Proposal Role of the Ovarian Derived Prorenin to Angiotensin Cascade (ODPAC)

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Tissue Renin-Angiotensin Systems

Abstract

Despite the fact that it was first described over thirty years ago, the factors responsible for (OHSS) have continued to elude investigators. During this time, several theories have been popularized but none have become widely accepted. Recently, it has been suggested that angiotensin II (Ang II) derived from the ovary plays an important role in the development of OHSS (1). This paper will briefly review previous theories and present the results of experiments performed at the University of Southern California School of Medicine that add weight to the notion that ODPAC is involved in OHSS.

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References

  1. Navot D, Bergh PA, Laufer N. Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil Steril 1992; 58: 249–261.

    PubMed  CAS  Google Scholar 

  2. Golan A, Ronel R, Herman A, Soffer Y, Weinraub Z, Caspi E. Ovarian hyperstimulation: An update review. Obstet Gynecol Surv. 1989; 44: 430–440.

    Article  PubMed  CAS  Google Scholar 

  3. McClure N, Leya J, Radwanska E, Rawlins R, Haning RV. Luteal phase support and severe ovarian hyperstimulation syndrome. Hum Reprod. 1992; 7: 758–764.

    PubMed  CAS  Google Scholar 

  4. Ferrareti AP, Gianaroli L, Diotallevi L, Festi C, Trounson A. Dopamine treatment for severe hyperstimulation syndrome. Hum Reprod. 1992; 7: 180–183.

    Google Scholar 

  5. Polishuk WZ, Schenker JG. Ovarian overstimulation syndrome. Fertil Steril. 1969; 20: 443–447.

    PubMed  CAS  Google Scholar 

  6. Schenker JG, Weinstein D. Ovarian hyperstimulation syndrome: A current survey. Fertil Steril. 1978; 20: 443–448.

    Google Scholar 

  7. Mozes M, Bogokowsky H, Antebi E, Lunenfeld B, Rabau E, David A, Serr DM, Salomy M. Thromboembolic phenomena after ovarian stimulation with human gonadotrophins. Lancet. 1965; ii: 1213–1215.

    Article  Google Scholar 

  8. Haning RV, Strawn EY, Nolten WE. Pathophysiology of the ovarian hyperstimulation syndrome. Obstet Gynecol. 1985; 66: 220–225.

    PubMed  Google Scholar 

  9. Engel T, Jewelicz R, Dyrenfurth I, Speroff L, Vande Wiele RL. Ovarian hyperstimulation syndrome. Amer J Obstet Gynecol. 1972; 112: 1052–1060.

    CAS  Google Scholar 

  10. Davis JS. Hormonal control of plasma and erythrocyte volume of rat uterus. Amer J Physiol. 1960; 199: 841–846.

    PubMed  CAS  Google Scholar 

  11. Miles RA, Lobo RA, Paulson RJ, Sauer MV. The use of testolactone to prevent ovarian hyperstimulation syndrome (OHSS) after gonadotropin therapy. Abstract. Presented at the th meeting of the Society for Gynecologic Investigation. 1992.

    Google Scholar 

  12. Hurwitz A, Krausz M, Eldar-Geva T, Yagel S, Schenker JG, Palti Z, Laufer N. Production of 6-keto-PGF1α in hyperstimulated cycles: In vivo and in vitro studies. Int J Fertil. 1991; 36: 252–256.

    PubMed  CAS  Google Scholar 

  13. Armstrong DT, Grinwich DL. Blockade of spontaneous and LH-induced ovulation in rats by indomethacin, an inhibitor of prostaglandin biosynthesis. Prostaglandins. 1972; 1: 21–28.

    PubMed  CAS  Google Scholar 

  14. Pride SM, Ho Yuen B, Moon YS, Leung PCS. Relationship og gonadotropin releasing hormone, danazol, and prostaglandin blockade to ovarian enlargement and ascites formation of the ovarian hyperstimulation syndrome in the rabbit. Amer J Obstet Gynecol. 1986; 154: 1155–1160.

    CAS  Google Scholar 

  15. Zaidise I, Friedman M, Lindenbaum ES, Askenazi R, Peretz BA, Paldi E. Serotonin and the ovarian hyperstimulation syndrome. Europ J Obstet Gynecol Reprod Biol. 1983; 15: 55–60.

    Article  CAS  Google Scholar 

  16. Erlik Y, Naot Y, Friedman M, Ben-David E, Paldi E. Histamine levels in ovarian hyperstimulation syndrome. Obstet Gynecol. 1979; 53: 580–582.

    PubMed  CAS  Google Scholar 

  17. Szego CM, Gitin ES. Ovarian histamine depletion during acute hyperemic response to luteinizing hormone. Nature. 1964; 201:682.

    Article  PubMed  CAS  Google Scholar 

  18. Knox GE. Antihistamine blockade of the ovarian hyperstimulation syndrome. Amer J Obstet Gynecol. 1974; 118: 992–994.

    CAS  Google Scholar 

  19. Loukides JA, Loy RA, Edwards R, Honig J, Visintin I, Polan ML. Human follicular fluids contain tissue macrophages. J Clin Endoc Metab. 1990; 71: 1363–1367.

    Article  CAS  Google Scholar 

  20. Friedlander MA, Loret de Mola JR, Goldfarb JM. Elevated levels of interleukin-6 in ascites and serum from women with ovarian hyperstimulation syndrome. Fertil Steril. 1993; 60: 826–833.

    PubMed  CAS  Google Scholar 

  21. Culler MD, Tarlatzis BC, Lightman A, Fernandez LA, DeCherney AH, Negro-Vilar A, Naftolin F. Angiotensin II-like immunoreactivity in human ovarian follicular fluid. J Clin Endoc Metab. 1986; 62: 613–615.

    Article  CAS  Google Scholar 

  22. Derkx FHM, Alberda AT, Zeilmaker GH, Schalekamp MADH. High concentrations of immunoreactive renin, prorenin, and enzymatically-active renin in human ovarian follicular fluid. Br J Obstet Gynecol. 1987; 94: 4–9.

    Article  CAS  Google Scholar 

  23. Itskovitz J, Rubattu S, Levron J, Sealey JE. Highest concentrations of prorenin and human chorionic gonadotropin in gestational sacs during early human pregnancy. J Clin Endoc Metab. 1992; 75: 906–910.

    Article  CAS  Google Scholar 

  24. Bisset GS, Lewis GP. Spectrum of pharmacological activity in some biologically active peptides. Br J Pharmacol. 1962; 19: 168–182.

    CAS  Google Scholar 

  25. Robertson AL, Khairallah PA. Effects of angiotensin II and some analogues on vascular permeability in the rabbit. Circ Res. 1972; 31: 923–931.

    Article  PubMed  CAS  Google Scholar 

  26. Morel NML, Petruzzo PP, Hechtman HB, Shepro D. Inflammatory agonists that increase microvascular permeability in vivo stimulate cultured pulmonary microvessel endothelial cell contraction. Inflammation. 1990; 14: 571–582.

    Article  PubMed  CAS  Google Scholar 

  27. Franken AAM, Derkx FHM, Schalekamp MADH, Manint’Veld AJ, Hop WCJ, van Rens, EH, de Jong PTVM. Association of high plasma prorenin with diabetic nephropathy. J Hypert. 1988; 6s4:s461–s463.

    Google Scholar 

  28. Larsen M, Hommel E, Parving HH, Lund-Andersen H. Protective effect of captopril on the blood retina barrier in normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy. Graef Arch Clin Exper Opthalm. 1990; 228: 505–509.

    Article  CAS  Google Scholar 

  29. Ikeda T, Nakayama D, Gomi T, Sakurai J, Yamazaki T, Yuhara M. Captopril, an angiotensin I-converting enzyme inhibitor, decreases proteinuria in hypertensive patients with renal diseases. Nephron. 1989; 52: 72–75.

    Article  PubMed  CAS  Google Scholar 

  30. Ruilope LM, Miranda B, Oliet A, Millet VG, Rodicio JL, Romer JC, Raij L. Control of hypertension with the angiotesnin converting enzyme inhibitor captopril reduces glomerular proteinuria. J Hypert. 1988; 6s4:s467–s469.

    Google Scholar 

  31. Stornello M, Valvo EV, Puglia N, Scapellato L. Angiotensin converting enzyme inhibition with a low dose of enalapril in normotensive diabetics with persistent proteinuria. J Hypert. 1988; 6s4:s464–s466.

    Google Scholar 

  32. Navot D, Margoliath EJ, Laufer N, Birkinfeld A, Relou A, Rosier A, Schenker JG. Direct correlation between plasma renin activity and severity of the ovarian hyperstimulation syndrome. Fertil Steril. 1987; 48: 57–61.

    PubMed  CAS  Google Scholar 

  33. Ong ACM, Eisen V, Rennie DP, Homburg R, Lachelin GCL, Jacobs HS, Slater JDH. The pathogenesis of the ovarian hyperstimulation syndrome (OHS): a possible role for ovarian renin. Clin Endoc. 1991; 34: 43–49.

    Article  CAS  Google Scholar 

  34. Morris RS, Wong IL, Hatch IE, Paulson RJ, Lobo RA. Prorenin is elevated in PCO and may reflect hyperandrogensim. Abstract presented at the XXth meeting of the Society for Gynecologic Investigation. Chicago, IL. March 1994. Submitted to the J of the Soc Gyn Invest.

    Google Scholar 

  35. Morris RS, Wong IL, Gentschein E, Sauer MV, Lobo RA, and Paulson RJ. Angiotensin converting enzyme inhibition for the prevention of ovarian hyperstimulation syndrome: A randomized prospective, placebo controlled double blind trial. Abstract presented at the th meeting of the Pacific Coast Fertility Society, Indian Wells, CA April 19–23, 1994. Submitted to Hum Reprod.

    Google Scholar 

  36. Morris RS, Wong IL, Paulson RJ. Angiotensin converting enzyme inhibition in the gonadotropin stimulated rabbit: effect on estradiol production. Submitted to Fertil Steril.

    Google Scholar 

  37. Morris RS, Lindheim SR, Paulson RJ, McConnel RA, Sauer MV. Angiotensin converting enzyme inhibition dramatically reverses lutealphase steroid production in oocyte donors. Abstract presented at the 38th Annual meeting of the American Fertility Society. Montreal, Canada, March 1994. Submitted to Fertil Steril.

    Google Scholar 

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© 1995 Springer Science+Business Media New York

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Morris, R.S. et al. (1995). The Pathophysiology of Ovarian Hyperstimulation Syndrome (OHSS). In: Mukhopadhyay, A.K., Raizada, M.K. (eds) Tissue Renin-Angiotensin Systems. Advances in Experimental Medicine and Biology, vol 377. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-0952-7_28

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  • DOI: https://doi.org/10.1007/978-1-4899-0952-7_28

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-0954-1

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