Summary
Cell-derived microparticles (MPs) are known to be elevated in a number of diseases
related to arterial and venous thromboembolism (VTE), such as acute myocardial infarction,
VTE (deep-vein thrombosis and pulmonary embolism) and peripheral arterial disease.
IVF-associated pregnancies have previously been shown to be associated with an increased
incidence of VTE, mechanisms behind being unknown and sparsely studied. Our objective
was to assess cell activation during IVF through analysis of MP levels and phenotype
following ovarian stimulation. Thirty-one women undergoing IVF were included and blood
samples were collected at down regulation of oestrogen and at high level stimulation
with 10- to 100-fold increased endogenous oestrogen levels. MPs were analysed by flow
cytometry and phenotyped according to size and protein expression. We found that overall
phosphatidylserine positive platelet-, endothelial- and monocyte-derived MPs significantly
increased following ovarian stimulation with increased levels of platelet activation
markers CD40 ligand and P-selectin. Furthermore, there was an increase in endothelial-derived
MPs exposing activation marker E-selectin and monocyte-derived MPs, while neutrophil-derived
MPs decreased slightly. In conclusion we found a major increase in MPs and markers
indicating cell activation in parallel with the profound oestrogen boost during IVF.
To assess whether these changes in MPs are associated with thromboembolic events requires
extended longitudinal studies.
Keywords
Cell-derived microparticles - oestrogen -
in vitro fertilisation - IVF - venous thromboembolism