Letsyn D. V.

ASSESSMENT OF ALDOSTERONE AND ANTIDIURETIC HORMONE LEVELS IN WOMEN UNDERGOING ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS

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About the author:

Letsyn D. V.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

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Dysregulation of intravascular volume and water-electrolyte homeostasis plays a significant role in the pathogenesis of ovarian hyperstimulation syndrome. A reduction in circulating blood volume, resulting from increased permeability of the microvasculature, can activate neurohumoral mechanisms that maintain hemodynamics-specifically, the renin-angiotensin-aldosterone system and the antidiuretic hormone system. Aim of the study is o determine aldosterone and antidiuretic hormone concentrations in women by assessing the clinical and pathogenetic role of disturbances in the neuroendocrine regulation of water-salt metabolism, with the aim of individualizing pharmacological correction within assisted reproductive technology programs. 110 patients who were included in the program of assisted reproductive technologies were examined. The introduction of an ovulation trigger in patients of subgroups I and II was accompanied by a statistically significant increase in aldosterone and antidiuretic hormone levels compared to baseline values. The most pronounced changes in both hormones were observed in patients of subgroup II. In the control group, a significant increase in aldosterone and antidiuretic hormone levels was also noted following intrauterine insemination, though it was less pronounced than in patients of the main subgroups. The introduction of an ovulation trigger is accompanied by the activation of aldosterone, and vasopressin-mediated mechanisms regulating water-electrolyte homeostasis, this may reflect the body’s systemic response to controlled ovarian stimulation and be associated with a risk of hemodynamic and water-electrolyte alterations.

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Bibliography:

1. ESHRE Guideline Group on Ovarian Stimulation. ESHRE guideline: ovarian stimulation for IVF/ICSI: an update in 2025. Human Reproduction. 2026;41(4):498-514.
2. Buckett W, Sylvestre C, Liu K, Mahutte N, Min J, Roberts J. et al. Management of moderate and severe ovarian hyperstimulation syndrome: a Canadian Fertility and Andrology Society clinical practice guideline. Reproductive BioMedicine Online. 2026;52:105541. DOI: https://doi.org/10.1016/j.rbmo.2026.105541
3. Hamoda H, Drakeley AJ, Brian K, Evbuomwan IO, Mathur R. The Management of Ovarian Hyperstimulation Syndrome Green-Top Guideline No. 5. BJOG. 2026;133(7):50-69. DOI: https://doi.org/10.1111/1471-0528.70195
4. American Society for Reproductive Medicine. Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline. Fertility and Sterility. 2024;121(2):230-245.
5. Palomba S, Costanzi F, Nelson SM, Caserta D, Humaidan P. Interventions to prevent or reduce the incidence and severity of ovarian hyperstimulation syndrome: a systematic umbrella review of the best clinical evidence. Reproductive Biology and Endocrinology. 2023;21:67. DOI: https://doi.org/10.1186/s12958-023-01113-6
6. Palomba S, Costanzi F, Nelson SM, Besharat A, Caserta D, Humaidan P. Beyond the Umbrella: A Systematic Review of the Interventions for the Prevention of and Reduction in the Incidence and Severity of Ovarian Hyperstimulation Syndrome in Patients Who Undergo In Vitro Fertilization Treatments. International Journal of Molecular Sciences. 2023;24(18):14185. DOI: https://doi.org/10.3390/ijms241814185
7. Velthuis E, Hubbard J, Longobardi S, D’Hooghe T. The Frequency of Ovarian Hyperstimulation Syndrome and Thromboembolism with Originator Recombinant Human Follitropin Alfa (GONAL-f) for Medically Assisted Reproduction: A Systematic Review. Advances in Therapy. 2020;37:4831–4847.
8. Schirmer DA 3rd, Kulkarni AD, Zhang Y, Kawwass JF, Boulet SL, Kissin DM. Ovarian hyperstimulation syndrome after assisted reproductive technologies: trends, predictors, and pregnancy outcomes. Fertility and Sterility. 2020;114(3):567-578. DOI: https://doi.org/10.1016/j.fertnstert.2020.04.004
9. Ovarian Stimulation TEGGO, Bosch E, Broer S, Griesinger G, Grynberg M, Humaidan P, et al. ESHRE guideline: ovarian stimulation for IVF/ICSI. Hum Reprod Open. 2020;2020(2):hoaa009. DOI: https://doi.org/10.1093/hropen/hoaa009
10. Liu J, Liu F, Xu W, Zhang L, Tian Q, Du L, et al. Risk prediction models for ovarian hyperstimulation syndrome: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2025;25(1):860.
11. He L, Chen W, Lin J, Hao L, Wan F, Fu Y, et al. Pre-trigger risk scoring for moderate-to-severe ovarian hyperstimulation syndrome in in vitro fertilization and intracytoplasmic sperm injection cycles. Journal of Ovarian Research. 2026;19:149. DOI: https://doi.org/10.1186/s13048-026-02060-7
12. Berkovitz-Shperling R, Samara N, Meir R, Dominsky O, Azem F, Feferkorn I. et al. Severe ovarian hyperstimulation syndrome following sole gonadotropin-releasing hormone agonist trigger: a case series and literature review. Archives of Gynecology and Obstetrics. 2024;310(5):2297-2304. DOI: https://doi.org/10.1007/s00404-024-07740-7
13. Dziuba D. O. Porushennia vodno-elektrolitnoho balansu ta yikh korektsiia. Hostri ta nevidkladni stany u praktytsi likaria. 2017;3:17-21. [in Ukrainian].
14. The ESHRE Guideline Group. ESHRE guideline: ovarian stimulation for IVF/ICSI. Human Reproduction Open. 2020;2020(2):009.
15. Khmil MS. Modern approaches to the treatment of infertility in women with polycystic ovarian syndrome in assisted reproductive technology programs. Current issues of pediatrics, obstetrics and gynecology. 2020;1:108-115.
16. Lytvynova LO, Hrechyshkina NV, Artemchuk LI, Tonokovyd OB, Slutu NIu. Aktualnist vykorystannia dopomizhnykh reproduktyvnykh tekhnolohii v suchasnykh umovakh v Ukraini. Klinichna ta profilaktychna medytsyna. 2023;2(24):68-74. [in Ukrainian].
17. Khmil SV, Pidhaina IIa. Klinichni rezultaty u zhinok iz bezpliddiam na tli endometriozu v protokolakh dopomizhnykh reproduktyvnykh tekhnolohii. Zbirnyk naukovykh prats Asotsiatsii akusheriv-hinekolohiv Ukrainy. 2023;2(50):95-103. [in Ukrainian].
18. Pidhaina IIa, Khmil SV. Rezultaty likuvannia endometriozu yaiechnykiv u prohramakh dopomizhnykh reproduktyvnykh tekhnolohii. Visnyk sotsialnoi hihiieny ta orhanizatsii okhorony zdorovia Ukrainy. 2023;(4):75-80. [in Ukrainian].
19. Beniuk VO, Vyhivska LM. Vyznachennia osoblyvostei perebihu vahitnosti ta polohiv, stanu ploda i novonarodzhenoho u vahitnykh pislia zastosuvannia dopomizhnykh reproduktyvnykh tekhnolohii (dani retrospektyvnoho analizu). Ukrainskyi zhurnal Zdorovia zhinky. 2023;5(168):4-7. [in Ukrainian].
20. Vyhivska LM. Analiz perynatalnykh naslidkiv na foni zaproponovanoho likuvalnoho kompleksu u vahitnykh pislia zastosuvannia dopomizhnykh reproduktyvnykh tekhnolohii. Reproduktyvne zdorovia zhinky. 2023;(8):39-46. [in Ukrainian].
21. Nadon VV, Isaiev AN, Ruban OO, Brovchenko TI. The private-legal nature of the application of the methods of assisted reproductive technologies in Ukraine. Wiadomości Lekarskie. 2024;77(7):1476-1484.
22. Orel LV, Savchenko VM, Partenadze OA, Cherneha RT, Baitaliuk OM. Pravove rehuliuvannia zastosuvannia reproduktyvnykh tekhnolohii v Ukraini. Reproduktyvne zdorovia zhinky. 2024;(8):44-53. [in Ukrainian].
23. Pravak YuB. Patohenetychne obhruntuvannia preventyvnoi korektsii pry bezpliddi na tli metabolichnoho syndromu [dysertatsiia]. Ternopil: Ternopilskyi natsionalnyi medychnyi universytet imeni I. Ya. Horbachevskoho MOZ Ukrainy; 2025. 214 p. [in Ukrainian].

Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 309-313 pages, index UDC 618.177-089.888.11:577.175.5:577.175.343]-074

DOI:

10.29254/2077-4214-2026-3-182-309-313