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Hum. Reprod. Advance Access published online on July 21, 2005
Human Reproduction, doi:10.1093/humrep/dei199
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
Received April 25, 2005
Revised June 2, 2005
Accepted June 8, 2005

Article

Microvascular dysfunction in women with polycystic ovary syndrome

K. Lakhani 1*, A. Leonard 2, A.M. Seifalian 3, and P. Hardiman 2

1 Ultrasound Department, North Middlesex Hospital, London
2 University Department of Obstetrics and Gynaecology, Royal Free and University College Medical School, University College London, London
3 Vascular Haemodynamic Unit, University Department of Surgery, Royal Free Hospital, London, UK


  Abstract

BACKGROUND: Polycystic ovary syndrome (PCOS) is associated with multiple cardiovascular risk factors and an increased prevalence of arterial dysfunction. However, microvascular dysfunction in PCOS has not been assessed. METHODS: Subjects comprised 12 women with PCOS and 12 age-matched controls with normal ovaries. Microvascular function was assessed by observing forearm skin microvascular erythrocyte flux responses, to cumulative iontophoretic doses of 1% (w/v) acetylcholine (ACh) and 1% (w/v) sodium nitroprusside (SNP), using laser Doppler imaging. RESULTS: Basal microvascular perfusion was comparable in PCOS and controls. The increase in skin microvascular perfusion in response to ACh was however generally blunted in PCOS women (P = 0.018). Peak Ach-induced erythrocyte flux was also less (p < 0.04) in PCOS women (125.1 ± 21.7, i.e. 5.3-fold basal flux) than in controls (200.8 ± 28.5, i.e. 8.3-fold basal flux). Analysis of covariance indicated this effect was unrelated to differences in body mass index or serum testosterone but serum insulin may be a weak confounder. No differences were noted between the PCOS and control groups in their response to SNP. CONCLUSION: Despite its limited sample size studied, this is the first demonstration that women with PCOS exhibit microvascular endothelial dysfunction, indicated by an inhibited vasodilatory response to ACh.

Keywords: acetylcholine/endothelium/erythrocyte flux/microcirculation/polycystic ovary syndrome.
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