WS03‐10Vasoactive substances and infertility

Abstract

The regulation and significance of ovarian and uterine haemodynamics in human reproductive pathophysiology has been largely studied. In women, ovarian vascularization seems to be responsible for the selection and maturation of follicles both in spontaneous and stimulated IVF cycles while endometrial receptivity is related to uterine blood flow and implicated in the achievement of pregnancy. In patients who underwent to IVF cycles, the PI of both uterine and spiral arteries is significantly lower in patients who became pregnant in comparison with nonpregnant and is associated with significantly lower endometrial cell thromboxane concentrations than non pregnant patients. In poor responders women it has been demonstrated the role of l‐arginine in improving uterine and follicular Doppler flow and in increasing ovarian response to gonadotrophin. Recently, in a total of 41 patients undergoing to assisted reproduction, an higher number of oocytes collected and embryos transferred was observed in normo‐responders than in poor‐responders patients. Furthermore follicular vascular endothelial growth factor (VEGF) resulted inversely correlated with retrieved oocytes (r = −0.942; p = 0.0017). In addition significant higher uterine and perifollicular Doppler flow resistances were observed in poor‐responders women. The pregnancy rate/cycle was significantly higher in normo‐responders (26%) than poor‐responders (6%; p = 0.037) patients.In conclusion, vasoactive substances improve ovarian response to gonadotrophin and allow a better management of ovarian stimulation in infertile patients.