Increased induced monocyte tissue factor expression by plasma from patients with severe ovarian hyperstimulation syndrome

Objective: To investigate whether monocyte expression of tissue factor is increased by plasma from patients with severe ovarian hyperstimulation syndrome (OHSS). Design: Prospective longitudinal study. Setting: Assisted Reproduction Unit of the Hospital Clinic i Provincial in Barcelona,a tertiary care setting. Patients: Nine IVF patients with severe OHSS. Interventions: Pretreatment with leuprolide acetate was followed by gonadotropin treatment for ovarian follicular stimulation. After administration of hCG, a standard IVF-ET procedure was performed. Main Outcome Measures: Measurement during the syndrome and 4 to 5 weeks after recovery of induced monocyte tissue factor expression. Results: In each of the nine patients, plasma obtained during the syndrome induced a significantly higher proportion of monocytes expressing tissue factor and a significantly higher intensity of tissue factor expression on monocytes than plasma obtained after recovery and control plasma. Conclusions: Procoagulant activity of blood monocytes, which is mediated principally by tissue factor expression, is increased in patients with severe OHSS. This fact may be important in thrombotic events associated with the syndrome.