Evaluation of the impact of laparoscopic ovarian drilling on Doppler indices of ovarian stromal blood flow, serum vascular endothelial growth factor, and insulin-like growth factor-1 in women with polycystic ovary syndrome.
OBJECTIVE
To study the serum levels and correlation of vascular endothelial growth factor (VEGF), insulin-like growth factor 1 (IGF-1), hormonal profile, and Doppler blood flow changes within the ovarian stroma before and after laparoscopic ovarian drilling (LOD) in women with clomiphene-resistant polycystic ovary syndrome (PCOS).


METHODS
Prospective controlled study.


METHODS
University teaching hospital.


METHODS
Twenty-five women with clomiphene-resistant PCOS (group 1) and 20 women with regular menstrual cycles as a comparison group (group 2).


METHODS
Laparoscopic ovarian drilling.


METHODS
Serum levels of VEGF, IGF-1, and Doppler indices of ovarian stromal blood flow.


RESULTS
The serum levels of VEGF, IGF-1, T, and LH were significantly higher in group 1 before LOD than in group 2. The Doppler indices (pulsatility index and resistance index) of ovarian stromal blood flow were also significantly lower in group 1 before LOD than in group 2. The serum levels of VEGF, T, and LH were significantly reduced in group 1 after LOD compared with in group 1 before LOD. Doppler indices (pulsatility index and resistance index) of ovarian stromal blood flow were significantly increased after LOD. The VEGF levels before LOD were positively correlated with IGF-1, LH, and T. After LOD, the VEGF levels were positively correlated with LH and T.


CONCLUSIONS
Higher serum levels of VEGF and IGF-1 may explain the increased vascularity that was demonstrated by Doppler blood flow measurements in PCOS. Laparoscopic ovarian drilling reduced serum VEGF, IGF-1, T, and LH and reduced ovarian blood flow velocities, which may explain the reduction of ovarian hyperstimulation syndrome in women with PCOS after LOD.
Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt. ahmedamen1@yahoo.com
Ahmed F
AF
Amin
Diaa-Eldeen M
DE
Abd el-Aal
Atef M
AM
Darwish
Abdel-Raheim M A
AR
Meki
D043925:Angiogenesis Inducing Agents / Q000097:blood*; D001783:Blood Flow Velocity / Q000502:physiology; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D010535:Laparoscopy; D007986:Luteinizing Hormone / Q000097:blood; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood; D018615:Ultrasonography, Doppler, Color; D042461:Vascular Endothelial Growth Factor A
D043925:Angiogenesis Inducing Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D013739:Testosterone; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone