Follicular fluid vascular endothelial growth factor concentrations are increased during GnRH antagonist/FSH ovarian stimulation cycles.

Background: The aim of this study was to investigate the effect of GnRH antagonists (GnRH-ant) on follicular fluid vascular endothelial growth factor (FF VEGF). Methods: Sixty women undergoing assisted reproduction were randomised (computer-generated randomisation list) and assigned to two different GnRH analogue regimens: GnRH agonist (GnRH-a) (Group A; n = 30) and GnRH-ant (Group B; n = 30). Results: Mean (S.D.) FF VEGF concentrations were 1598 612 pg/mL and 2906 1558 pg/mL for Groups A and B, respectively ( p < 0.001). In the women treated with GnRH-ant, we found a statistically significant reduction in serum LH levels (1.72 0.74 IU/L in Group A versus 0.93 0.43 IU/L in Group B, p < 0.001), in serum oestradiol (E2) levels (1562.1 410.7 pg/mL in Group A versus 1214.67 779.9 pg/mL in Group B, p < 0.05), in FF E2 levels (1146 593 ng/mL in Group A versus 621 435 ng/mL in Group B, p < 0.05), and in FF androstenedione levels (136 55 ng/mL in Group A versus 78 31 ng/mL in Group B, p < 0.001), as well as a reduction in the number of pregnancies, though not statistically significant (23.3% in Group A versus 16.6% in Group B). Conclusion: The increase in FF VEGF levels in women treated with GnRH-ant might be explained by a suppression of LH and E2 levels.