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 endothelia l growth factor (VEGF) concentrations and Doppler blood flow changes w ithin the ovarian stroma of women with polycystic ovaries (PCO) and wo men with normal ovaries. Pulsed and colour Doppler blood flows within the ovarian stroma were recorded, and serum VEGF concentrations measur ed, in the early follicular phase (days 2-3 of a menstrual cycle) in 6 0 women undergoing ovarian stimulation for in-vitro fertilization. 36 women had normal ovaries, 14 women had PCO as seen on pelvic ultrasoun d 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 respective ly) 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 wer e 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 wer e 9 +/- 3 and 11 +/- 3 cm/s in women with PCO and PCOS respectively co mpared with women with normal ovaries (5.8 +/- 1.5 cm/s). Serum VEGF c oncentrations 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 demo nstrated by Doppler blood flow velocity measurements in these women. T he results may explain the higher risk of ovarian hyperstimulation syn drome in programmes of ovarian stimulation in patients with PCO compar ed with those with normal ovaries.