Utero-ovarian arterial blood flow and hormonal profile in patients with polycystic ovary syndrome

Abstract

Utero-ovarian arterial blood flow and hormonal profile were evaluated in 20 patients with polycystic ovary syndrome (PCOS) and in 22 patients with normal menstrual cycle (NMC) undergoing in-vitro fertilization (IVF) treatment. In this controlled prospective clinical study the vascular impedance in the utero-ovarian arteries was measured in both groups on days 4, 13, 22 [introduction of gonadotrophin releasing hormone agonist (GnRHa) administration], 36 (after the 14 day GnRHa administration) and on the day of human chorionic gonadotrophin (HCG) administration. Simultaneously, serum concentrations of luteinizing hormone (LH), follicle stimulating hormone (FSH), oestradiol, androstendione and sex hormone-binding globulin (SHBG) were determined. In the PCOS group significantly (P < 0.05) higher concentrations of FSH and LH were found on day 22, whereas the excess of androstendione production and lower SHBG values were registered throughout the studied cycles. Also, no effect of the 14 day GnRHa administration on the androstendione discharge was registered. In both groups the serum LH concentration decreased significantly (P < 0.05); however, the value remained significantly (P < 0.05) higher in the PCOS group. In the PCOS group no changes regarding the vascular impedance in the uterine artery were registered in the phase of the cycle preceding the GnRHa administration. The resistance index (RI) on day 22 of the cycle was 0.86 in the PCOS and 0.82 in the NMC group. In the NMC group the active ovary showed dramatic changes during the cycle, with vascular impedance almost constant throughout the cycle in the inactive ovary. In the PCOS group the vascular impedance to ovarian arterial blood flow in both ovaries was similar to that in inactive ovaries in the NMC group. After the 14 day GnRHa administration the utero-ovarian vascular impedance was high in both groups with changes registered only in the NMC group, as the PCOS patients exhibited maximal vascular impedance throughout the cycle. On the day of HCG administration strong negative correlation between the vascular impedance in the uterine artery and the serum oestradiol concentration in stimulated cycles was found in both groups, but not in anovulatory PCOS patients. As in PCOS patients the utero-ovarian vascular impedance was raised throughout the cycle we concluded that the 14 day GnRHa administration neither affected the utero-ovarian arterial blood flow nor suppressed the androstendione discharge.