Human Reproduction, Vol 13, 815-821, Copyright © 1998 by Oxford University Press
E Vrtacnik-Bokal and H Meden-Vrtovec
Utero-ovarian arterial blood flow and hormonal profile were evaluated in 20
patients with polycystic ovary syndrome (PCOS) and in 22 patients with
normal menstrual cycle (NMC) undergoing in-vitro fertilization (IVF)
treatment. In this controlled prospective clinical study the vascular
impedance in the utero-ovarian arteries was measured in both groups on days
4, 13, 22 [introduction of gonadotrophin releasing hormone agonist (GnRHa)
administration], 36 (after the 14 day GnRHa administration) and on the day
of human chorionic gonadotrophin (HCG) administration. Simultaneously,
serum concentrations of luteinizing hormone (LH), follicle stimulating
hormone (FSH), oestradiol, androstendione and sex hormone-binding globulin
(SHBG) were determined. In the PCOS group significantly (P < 0.05)
higher concentrations of FSH and LH were found on day 22, whereas the
excess of androstendione production and lower SHBG values were registered
throughout the studied cycles. Also, no effect of the 14 day GnRHa
administration on the androstendione discharge was registered. In both
groups the serum LH concentration decreased significantly (P < 0.05);
however, the value remained significantly (P < 0.05) higher in the PCOS
group. In the PCOS group no changes regarding the vascular impedance in the
uterine artery were registered in the phase of the cycle preceding the
GnRHa administration. The resistance index (RI) on day 22 of the cycle was
0.86 in the PCOS and 0.82 in the NMC group. In the NMC group the active
ovary showed dramatic changes during the cycle, with vascular impedance
almost constant throughout the cycle in the inactive ovary. In the PCOS
group the vascular impedance to ovarian arterial blood flow in both ovaries
was similar to that in inactive ovaries in the NMC group. After the 14 day
GnRHa administration the utero-ovarian vascular impedance was high in both
groups with changes registered only in the NMC group, as the PCOS patients
exhibited maximal vascular impedance throughout the cycle. On the day of
HCG administration strong negative correlation between the vascular
impedance in the uterine artery and the serum oestradiol concentration in
stimulated cycles was found in both groups, but not in anovulatory PCOS
patients. As in PCOS patients the utero- ovarian vascular impedance was
raised throughout the cycle we concluded that the 14 day GnRHa
administration neither affected the utero-ovarian arterial blood flow nor
suppressed the androstendione discharge.
ARTICLES
Utero-ovarian arterial blood flow and hormonal profile in patients with polycystic ovary syndrome
Department of Obstetrics and Gynaecology Ljubljana, University Medical Centre Ljubljana, Slovenia.
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