Effects of ovarian stimulation on blood pressure and plasma catecholamine levels

Effects of ovarian stimulation for in vitro fertilization on blood pressure and plasma catecholamine levels were studied in 10 women. The examinations were carried out before hormonal treatment with human menopausal gonadotropin (day three of the menstrual cycle, mean serum oestradiol concentration 0.2 nmol l-1, and on the day after ovulation induction with human chorionic gonadotropin (cycle days 10-12, mean serum oestradiol concentration 7.4 nmol l-1). Systolic and diastolic blood pressures (mean +/- SD) decreased 6.7 +/- 8.6 mm Hg, p = 0.049, and 5.3 +/- 4.7 mm Hg, p = 0.009, respectively), and venous plasma noradrenaline increased (42 +/- 44 pg ml-1, p = 0.02) during ovarian stimulation. No significant change was observed in either arterial noradrenaline, arterial adrenaline or venous adrenaline. After stimulation a positive correlation was observed between systolic blood pressure and arterial adrenaline (r = 0.73, p = 0.027), and between systolic blood pressure and the arterial-venous difference for adrenaline (r = 0.81, p = 0.007). The increased venous noradrenaline levels may be a reflex-mediated activation of the sympathetic nervous tone due to a decrease in blood pressure, or may indicate reduced neuronal re-uptake of released noradrenaline. The mechanisms behind the strong correlation between adrenaline and blood pressure are unclear, but may be induced by the supraphysiological oestradiol levels. Thus, adrenaline seems to be more important for blood pressure control in this particular setting.