Serum vascular endothelial growth factor concentrations and ovarian stromal blood flow are increased in women with polycystic ovaries

The aim of this study was to determine basal serum vascular endothelial growth factor (VEGF) concentrations and Doppler blood flow changes within the ovarian stroma of women with polycystic ovaries (PCO) and women with normal ovaries. Pulsed and colour Doppler blood flows within the ovarian stroma were recorded, and serum VEGF concentrations measured, in the early follicular phase (days 2-3 of a menstrual cycle) in 60 women undergoing ovarian stimulation for in-vitro fertilization. 36 women had normal ovaries, 14 women had PCO as seen on pelvic ultrasound examination and 10 had polycystic ovarian syndrome (PCOS). Mean +/- SD serum VEGF concentrations were significantly higher (P < 0.001) in women with PCO and PCOS (3.4 +/- 0.7 and 3.2 +/- 0.66 ng/ml respectively) compared with women with normal ovaries (2.3 +/- 0.5 ng/ml), Mean peak systolic blood flow velocity (PSV) and time-averaged maximum flow velocity (TAMXV) were significantly higher (P < 0.001) in women with PCO and PCOS compared with women with normal ovaries. The mean PSV were 15 +/- 4 and 16 +/- 4 cm/s in women with PCO and PCOS respectively, compared with 9 +/- 2 cm/s in women with normal ovaries. The TAMXV were 9 +/- 3 and 11 +/- 3 cm/s in women with PCO and PCOS respectively compared with women with normal ovaries (5.8 +/- 1.5 cm/s). Serum VEGF concentrations were positively correlated with PSV (r = 0.44, P = 0.001) and TAMXV (r = 0.45, P < 0.000) in all three groups of women. Higher serum concentrations of VEGF in women with PCO and PCOS may relate to the increased vascularity that underlies the increased blood how demonstrated by Doppler blood flow velocity measurements in these women. The results may explain the higher risk of ovarian hyperstimulation syndrome in programmes of ovarian stimulation in patients with PCO compared with those with normal ovaries.