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A variety of cytokines are thought to be involved in pathophysiology of this syndrome.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A prospective cohort study invloving sixty intracytoplasmic sperm injection (ICSI) patients. On the day of hCG injection, we explored the threshold of larger follicles \u226511\u2009mm diameter with a count of \u226518 follicles for the high-risk moderate-to-severe OHSS and 13\u201318 follicles for the low-risk moderate-to-severe OHSS. Whereas larger follicles count of less than 13 were classified as normoresponders. Pooled follicular fluid (FF) samples of each patient were collected on the day of oocyte retrieval. Magnetic multiplex immunoassay was explored to measure the concentrations of some intrafollicular cytokines including: GM-CSF, INF-\u03b3, TNF-\u03b1, IL-10, CXCL8\/IL-8, IL-6, IL-5, IL-4, IL-2, and IL-1\u03b2. All sixty patients underwent controlled ovarian hyperstimulation (COH) with either GnRH agonist or antagonist protocols.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Intrafollicular TNF-\u03b1 concentration was significantly different (p &lt; 0.05) in the high-risk moderate-to-severe OHSS patients compared to low-risk moderate-to-severe OHSS patients and normoresponders. TNF-\u03b1 in FF had a negative correlation with the chance of high-risk moderate-to-severe OHSS. The differences in the risk of OHSS between patients who received GnRH agonist or antagonist were not significant (p &gt; 0.05).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In accordance to the negative correlation of TNF-\u03b1 and high risk of early OHSS, we did not expect TNF-\u03b1 to play a role in increasing vascular permeability in ovarian tissues. In addition, the risk of early moderate-to-severe OHSS was not affected by different GnRH superovulation protocols.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12884-020-03379-9","type":"journal-article","created":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T13:03:02Z","timestamp":1605186182000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prognostic role of follicular fluid tumor necrosis factor alpha in the risk of early ovarian hyperstimulation syndrome"],"prefix":"10.1186","volume":"20","author":[{"given":"Miaad Jabbar","family":"Alhilali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4664-2917","authenticated-orcid":false,"given":"Abbas","family":"Parham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Attaranzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malihe","family":"Amirian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Azizzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,12]]},"reference":[{"key":"3379_CR1","first-page":"3","volume":"6","author":"MM Alper","year":"2009","unstructured":"Alper MM, Smith LP, Sills ES. 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Written and verbal informed consents were sought from the study patients at the beginning of the study. The ethics committees approved the use of verbal consent to participate.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"691"}}