Ersin ONAT, Deniz DİRİK, Ahmet Ufuk KÖMÜROĞLU
Eastern Journal of Medicine (EJM) - 2026;31(4):858-864
This study aimed to evaluate the effect of silymarin on the concentrations of angiopoietin-2 (ANGPT-2), angiopoietin-1 (ANGPT-1), vascular endothelial growth factor-A (VEGF-A), and tumor necrosis factor-alpha (TNF-alpha) in an ovarian hyperstimulation syndrome (OHSS) model. Thirty-two 22-day-old female Wistar Albino rats were assigned to four groups: control, OHSS, OHSS + silymarin, and silymarin. The OHSS model was induced by pregnant mare serum gonadotropin (PMSG) followed by human chorionic gonadotropin (hCG). Silymarin was administered at a dose of 50 mg/kg. All animals were sacrificed on postnatal day 28. Serum and follicular fluid levels of VEGF-A, ANGPT-1, ANGPT-2, and TNF-alpha were measured using enzyme-linked immunosorbent assay. Biochemical parameters were evaluated. Statistical analysis was performed using one-way analysis of variance followed by Tukey post-hoc testing. In the OHSS group, serum VEGF-A and ANGPT-1 levels were significantly increased, whereas ANGPT-2 levels were significantly decreased compared with controls (p < 0.001). In the OHSS + silymarin group, VEGF-A and ANGPT-1 levels showed a decreasing trend, while ANGPT-2 levels demonstrated an increasing trend; however, some changes did not reach statistical significance. TNF-alpha levels in serum and follicular fluid did not differ significantly among groups (serum: p = 0.270; follicular fluid: p = 0.360). Albumin and total protein levels were lower in the control group compared with the other groups (p < 0.001). In this OHSS model, silymarin reduced VEGF-A and ANGPT-1 levels while increasing ANGPT-2. As a pilot proof-of-concept study, these findings suggest a modulatory role of silymarin in OHSS-related angiogenic imbalance. Larger studies and clinical trials are required to confirm these results.
