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.
Amin
Ahmed F
AF
Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Assiut, Egypt. ahmedamen1@yahoo.com
Abd el-Aal
Diaa-Eldeen M
DE
Darwish
Atef M
AM
Meki
Abdel-Raheim M A
AR
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