Histomorphological and histopathological evaluation of the effects of ovarian hyperstimulation syndrome on kidney, liver and lung in the rats: Ovarian hyperstimulation syndrome

Filiz Yılmaz; Orkun İlgen; Sefa  Kurt; Bayram Yılmaz

doi:10.5281/zenodo.8021810

Authors

Filiz Yılmaz Hitit University, Erol Olçok Training and Research Hospital, In Vitro Fertilization Center, Çorum, Turkey https://orcid.org/0000-0003-0505-3905
Orkun İlgen Dokuz Eylül University Faculty of Medicine, Department of Obstetrics and Gynecology, İzmir, Turkey https://orcid.org/0000-0002-0296-8504
Sefa Kurt Dokuz Eylül University Faculty of Medicine, Department of Obstetrics and Gynecology, İzmir, Turkey https://orcid.org/0000-0002-5144-0634
Bayram Yılmaz Hitit University Erol Olçok Training and Research Hospital, Department of Pathology, Çorum, Turkey https://orcid.org/0000-0002-1737-9446

DOI:

https://doi.org/10.5281/zenodo.8021810

Keywords:

Histomorphological evaluation, kidney, liver, lung, ovarian hyperstimulation syndrome

Abstract

Objective: Ovarian hyperstimulation syndrome (OHSS) is a life-threatening iatrogenic complication of controlled ovarian hyperstimulation (COH) used in the treatment of infertility. OHSS is classified into four categories according to the severity of clinical findings and symptoms as mild, moderate, severe and critical. Although it is a fatal condition in the advanced stages, its pathogenesis is still not clearly understood. Therefore, this study aimed to define the organ damage that plays a role in the clinical course of OHSS and to evaluate the effects of OHSS severity on the kidney, liver, and lung both histomorphologically and histopathologically.

Methods: Our study employed 21 female immature wistar albino rats (22 day-old, weighing 30-40 g). The rats were randomly divided into three groups: the control group (n=7), moderate OHSS group (n=7) and severe OHSS group (n=7). The OHSS model was established with sequential injections of pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG). Weight loss/gain (total body weight on the last day – total body weight on the first day) and organ weights of the rats were recorded. A routine tissue processing procedure was performed for the kidney, liver and lung fixed with formaldehyde. General histomorphological structures and damage evaluations of organs were made from sections stained with hematoxylin and eosin.

Results: In the intra-abdominal macroscopic evaluation, there was an increase in the size of the ovary, enlargement of the fallopian tubes and dilatation of the colon. The whole body and organ weights of the severe OHSS group were significantly higher than those of the control group (p<0.01). Statistically significant differences were noted in proximal tubule dilatation and increased necrosis in the kidney, sinusoidal and vascular congestion in the liver, degeneration in hepatocytes and in the scoring of lung damage (p<0.01).

Conclusion: Our study is the first to examine the histomorphological and histopathological effects of OHSS severity on the kidney, liver and lungs in rats. The data we obtained describe the organ damage caused by the severity of OHSS. Our findings can contribute to the elucidation of the pathogenesis of OHSS and the treatment process.

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