Is serum‐soluble vascular endothelial growth factor receptor‐1 of importance in unexplained infertility?

Katja-Anneli Wathén, Leila Unkila‐Kallio, Rita Isaksson, Aila Tiitinen, Ulf‐Håkan Stenman, Piia Vuorela
In: Acta Obstetricia et Gynecologica Scandinavica · 2008 · vol. 87(7) , pp. 738–744 · doi:10.1080/00016340802158321 · PMID:18607827 · W2100052671
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This study found that elevated VEGF and altered VEGF/sVEGFR-1 ratios in infertile women during natural and IVF cycles may contribute to unexplained infertility by impairing implantation.

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Abstract

OBJECTIVE: To analyze the role of vascular endothelial growth factor (VEGF) and its naturally occurring circulating antagonist, soluble VEGF receptor-1 (sVEGFR-1), in infertility. VEGF is a key angiogenic factor in the endometrial and ovarian cyclic processes that are crucial for fertility and sVEGFR-1 impairs its function and fertility in animals - less is known as regards human fertility. DESIGN: Case-control study. SETTING: University Central Hospital, a tertiary referral center. POPULATION: Women with unexplained infertility (n=15) and fertile controls (n=10) had serial blood samples collected during their natural cycles, and the infertile women during a subsequent in vitro fertilization (IVF) cycle. METHODS: Enzyme-linked immunosorbent assay was used for this study. MAIN OUTCOME MEASURES: Concentrations of VEGF and sVEGFR-1 in the natural cycles and of sVEGFR-1 during a subsequent IVF cycle. RESULTS: Plasma VEGF concentrations showed no cyclicity in fertile women, but were higher in the infertile group at the midluteal phase. Serum sVEGFR-1 concentrations were similar between the groups and between natural and IVF cycles. However, in infertile women, concentrations of sVEGFR-1 increased from the follicular phase to the luteal phase. In the follicular phase infertile women had a high ratio of VEGF/sVEGFR-1, which was decreased in the luteal phase. Both findings were associated with failure to achieve pregnancy in subsequent IVF cycles. CONCLUSIONS: One cause of unexplained infertility may be unbalanced secretion of sVEGFR-1 with concomitant changes in free VEGF during the transition from the follicular to the luteal phase. This aberration may be related to impaired implantation.

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