Human Reproduction, Vol 13, 651-655, Copyright © 1998 by Oxford University Press
R Agrawal, P Sladkevicius, L Engmann, GS Conway, NN Payne, J Bekis, SL Tan, S Campbell and HS Jacobs
The aim of this study was to determine basal serum vascular endothelial
growth factor (VEGF) concentrations and Doppler blood flow changes within
the ovarian stroma of women with polycystic ovaries (PCO) and women with
normal ovaries. Pulsed and colour Doppler blood flows within the ovarian
stroma were recorded, and serum VEGF concentrations measured, in the early
follicular phase (days 2-3 of a menstrual cycle) in 60 women undergoing
ovarian stimulation for in-vitro fertilization. 36 women had normal
ovaries, 14 women had PCO as seen on pelvic ultrasound examination and 10
had polycystic ovarian syndrome (PCOS). Mean+/-SD serum VEGF concentrations
were significantly higher (P < 0.001) in women with PCO and PCOS
(3.4+/-0.7 and 3.2+/-0.66 ng/ml respectively) compared with women with
normal ovaries (2.3+/-0.5 ng/ml). Mean peak systolic blood flow velocity
(PSV) and time-averaged maximum flow velocity (TAMXV) were significantly
higher (P < 0.001) in women with PCO and PCOS compared with women with
normal ovaries. The mean PSV were 15+/-4 and 16+/-4 cm/s in women with PCO
and PCOS respectively, compared with 9+/-2 cm/s in women with normal
ovaries. The TAMXV were 9+/-3 and 11+/-3 cm/s in women with PCO and PCOS
respectively compared with women with normal ovaries (5.8+/-1.5 cm/s).
Serum VEGF concentrations were positively correlated with PSV (r=0.44,
P=0.001) and TAMXV (r=0.45, P < 0.000) in all three groups of women.
Higher serum concentrations of VEGF in women with PCO and PCOS may relate
to the increased vascularity that underlies the increased blood flow
demonstrated by Doppler blood flow velocity measurements in these women.
The results may explain the higher risk of ovarian hyperstimulation
syndrome in programmes of ovarian stimulation in patients with PCO compared
with those with normal ovaries.
ARTICLES
Serum vascular endothelial growth factor concentrations and ovarian stromal blood flow are increased in women with polycystic ovaries
University College London Medical School, Department of Reproductive Endocrinology, The Middlesex Hospital, UK.
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