Doppler Study of the Uterine Arteries and Ovarian Stroma in Patients with Polycystic Ovary Syndrome

Abstract

Doppler analysis of the uterine arteries and ovarian stroma was performed by transvaginal ultrasound in 24 patients with polycystic ovary syndrome (PCOS) and 22 ovulatory women. Vascularization of the ovarian stroma was more abundant in patients with PCOS than in control women, but no significant difference in the mean pulsatility index (PI) was observed between groups (1.14 ± 0.28 for the PCOS group and 1.05 ± 0.19 for the control group). The mean PI of the uterine arteries was significantly higher in the PCOS group (PI = 3.7 ± 0.8) than in the control group (PI = 2.9 ± 0.4). In the patients with PCOS, no correlation was observed between PI and luteinizing hormone, testosterone or androstenedione levels. Obesity had no effect on uterine artery PI, with no significant differences in this index when the 3 groups were subdivided into obese and non-obese groups.

Impaired uterine perfusion associated with metabolic disorders in women with polycystic ovary syndrome

“…The results of our study and those of previous studies, which focused on uterine arterial blood flow resistance in the follicular phase (10–18), suggest that an elevated uterine arterial PI may be a cardiovascular risk factor. Furthermore, impaired uterine perfusion in the luteal phase may be closely associated with abnormalities in endometrium and failure of implantation.…”

“…Previous reports showed that the androstenedione (10,11), dehydroepiandrosterone (16), or dehydroepiandrosterone sulfate level (18) is associated with an elevated uterine arterial PI. However, there is a report that no correlation was observed between the androstenedione or testosterone level and the uterine arterial PI (17). Testosterone is known to induce vasodilation or vasoconstriction via endothelium‐dependent or endothelium‐independent mechanisms and by genomic or non‐genomic modes of action (31).…”

“…Previous studies reported that the uterine arterial PI in the follicular phase was associated with clinical and biochemical parameter abnormalities in women with PCOS, although all the reports were not always consistent (10–18). In the present study, the uterine arterial PI in the follicular phase was correlated with the LH level or LH/FSH ratio, which was a diagnostic criteria for PCOS.…”

“…Previous studies demonstrated an impaired uterine perfusion in women with PCOS in the follicular phase (10–18). Abnormal sex steroid hormones have been suggested as the cause for the elevated blood flow resistance in the uterine artery of women with PCOS (19).…”

Analysis of VEGFA Variants and Changes in VEGF Levels Underscores the Contribution of VEGF to Polycystic Ovary Syndrome

“…VEGF plays a critical role in ovarian folliculogenesis and normal reproductive function [8], highlighted by the findings that women with PCOS had increased serum levels of VEGF, which paralleled increases in Doppler flow velocities within ovarian vessels [10, 11]. High vascularization may result in abnormal growth of the theca interna, the site of androgen steroidogenesis, leading to hyperandrogenism, a hallmark of PCOS [12, 13]. VEGF is encoded by VEGFA gene, which is located on chromosome 6 (6p21.3), and comprises eight exons separated by seven introns [14].…”