Angiogenic growth factors and hemodynamics in the ovaries in women with menstrual dysfunction in the puberty

Abstract

To date, there is insufficient information in the literature on studies of the regulatory system of angiogenesis represented by vascular growth factors in women with menstrual dysfunction in the pubertal period.The objective: using the clinical material using clinical, laboratory and instrumental methods to study the state of angiogenic growth factors (VEGF and its receptors VEGF-R1, VEGF-R2) and ovarian hemodynamics, as well as expand the understanding of the mechanisms of development of luteal phase deficiency (LPD) in women with menstrual dysfunction in the puberty.Materials and methods. Studies were conducted among women of reproductive age from 19 to 32 years. According to the nature of the violations, the main group of women (n=90) who had a pathology of menstrual function in the puberty period was divided into 3 subgroups (n=30): the first – women with primary oligomenorrhea in the anamnesis, the second – with a late age menarche, the third – with puberty bleeding. The control group included women (n=30) with the correct rhythm of menstruation in puberty. Biochemical and ultrasound markers of angiogenesis were studied. Results. In women with menstrual dysfunction in the puberty, a decrease in the maximum systolytic blood flow velocity (Vmax) in the ovarian artery in the ovary with a preovulatory follicle was found compared with women in the control group (p<0,01). Blood flow in the arteries of the ovarian stroma with a preovulatory follicle was higher than in the arteries of the opposite ovary (p<0,05), but remained lower than in women with the correct rhythm of menstruation in puberty (p<0,05), and the lowest was noted in women with a primary history of oligomenorrhea (p<0,05). In the preovulatory period of the menstrual cycle in the ovarian arteries and arteries of the ovarian stroma, the vascular resistance indices did not significantly differ. During the corpus luteum stage, the vascular resistance indices in the arteries of the ovarian stroma with the corpus luteum are significantly lower than in the opposite ovary, the lowest in women with pubertal bleeding (subgroup 3). In all subjects from the main group, the vascular resistance indices in the arteries along the periphery of the corpus luteum are lower than along the periphery of the preovulatory follicle. A direct correlation between the vascular resistance indices in the arteries of the ovarian stroma with preovulatory follicle and VEGF and the inverse between VEGF-R1 in women with a history of primary oligomenorrhea indicate an improvement in vascularization of the preovulatory follicle due to newly formed and functioning capillaries.Conclusion. Studies have shown that the formation of a full-fledged preovulatory follicle and corpus luteum in the ovary is affected by microcirculation in the ovarian tissue, the state of which depends on the activity of the angiogenic system represented by VEGF and its receptors VEGF-R1 and VEGF-R2. The establishment of a correlation between VEGF and vascular resistance indices indicates the participation of angiogenic growth factors in ovarian hemodynamics during the formation of the preovulatory follicle in women with menstrual dysfunction in the pubertal period.