Elevated levels of CRP in ovarian hyperstimulation syndrome: An unrecognised potential hazard?

Objective: Elevated levels of C-reactive protein (CRP) were found recently to be a crucial marker for cardiovascular disease. This protein might have a role in endothelial cell activation, vascular damage and a thrombotic tendency. We sought to determine whether concentrations of CRP are altered in women with controlled ovarian hyperstimulation (COH) or hyperstimulation syndrome (OHSS). Design: A prospective cohort study. Setting: The gynecology department and IVF unit of the Lis maternity hospital. Population: Twenty women with OHSS, 20 women undergoing COH and 20 women who participated as controls were included in the study. Methods: Venous blood was withdrawn for analysis of high sensitive C-reactive protein (hs-CRP) using the Boering BN-II nephelometer. Main outcome measures: hs-CRP levels were determined. Results: There was a significant (P < 0.05) difference in the hs-CRP concentrations in women with OHSS compared with women with COH and controls. The respective values for hs-CRP were 19.0 [4.0], 7.0 [1.7] and 4.6 [1.1] mg/L. Conclusions: Women with OHSS have elevated concentrations of hs-CRP. This finding, previously believed to merely represent an acute phase response, may actually represent a yet unrecognised pathophysiological factor of this syndrome and pave the way for new investigational directions of this potentially hazardous condition.