Faricimab, a bispecific anti-VEGF/Ang-2 antibody, attenuates ovarian hyperstimulation syndrome in a rat model: correlation of ovarian VEGF immunostaining with serum VEGF

Ovarian hyperstimulation syndrome (OHSS) is a potentially life-threatening complication of assisted reproduction, primarily mediated by increased vascular endothelial growth factor (VEGF) activity. The purpose of this study was to evaluate the efficacy of faricimab, a novel bispecific monoclonal antibody, in preventing OHSS in an experimental rat model, and to compare its effects with those of established preventive agents, cabergoline and gonadotropin-releasing hormone (GnRH) antagonists. Thirty-six prepubertal female Wistar albino rats were randomized into six groups: Control, OHSS, OHSS+GnRH antagonist, OHSS + low-dose faricimab, OHSS + high-dose faricimab, and OHSS+cabergoline. OHSS was induced using gonadotropins followed by hCG. Treatments were administered over two days. Ovarian weight, follicle counts, VEGF immunostaining in ovarian tissue, and serum VEGF levels were assessed. A significant difference was found in secondary follicle ( p < 0.01), Graafian follicle ( p = 0.02), atretic follicle ( p = 0.02), and corpus luteum ( p = 0.01) counts in low-dose faricimab compared with the OHSS group, with all of these counts significantly lower in the low-dose faricimab group. VEGF staining intensity in ovarian tissue was significantly lower in the OHSS + low-dose faricimab, OHSS+high-dose faricimab, and OHSS+cabergoline groups than the OHSS group ( p < 0.01, p < 0.01, and p = 0.04, respectively). Serum VEGF levels were significantly lower in the OHSS + low-dose faricimab, OHSS+high-dose faricimab, and OHSS+cabergoline groups compared with the OHSS group ( p < 0.01, p < 0.01, and p = 0.01, respectively). Low-dose faricimab, a novel bispecific monoclonal anti-VEGF antibody, seems to be effective in reducing the risk of OHSS with decreasing VEGF expression in ovarian tissue and serum VEGF levels.