Journal of the Chinese Medical Association
Volume 72, Issue 4 , Pages 188-193, April 2009

Roles of Estrogen and Progesterone in Endometrial Hemodynamics and Vascular Endothelial Growth Factor Production

  • Lily Wen

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Lily Wen and Li-Hsun Chen contributed equally to this work.
    • ,
  • Li-Hsun Chen

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Institute of Anatomy and Cell Biology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Lily Wen and Li-Hsun Chen contributed equally to this work.
    • ,
  • Hsin-Yang Li

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Institute of Anatomy and Cell Biology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Division of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Hsin-Yang Li or Dr Yen-Jen Sung, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Sheng-Ping Chang

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Division of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Chen-Yi Liao

      Affiliations

    • Institute of Anatomy and Cell Biology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • ,
  • Kuan-Hao Tsui

      Affiliations

    • Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • ,
  • Yen-Jen Sung

      Affiliations

    • Institute of Anatomy and Cell Biology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Hsin-Yang Li or Dr Yen-Jen Sung, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Kuan-Chong Chao

      Affiliations

    • Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • Division of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 25 December 2008; accepted 16 March 2009.

Article Outline

Background

The endometrium becomes receptive to the embryo after sequential actions of estrogen and progesterone. The purpose of this study was to examine the effects of estrogen and progesterone on endometrial hemodynamics and on secretion of vascular endothelial growth factor (VEGF) from endometrial epithelial cells (EEC).

Methods

Six early postmenopausal women taking sequential estrogen and progestin [days 1–11: estradiol valerate (estrogen) 2 mg daily; days 12–21: estradiol valerate 2 mg plus norethisterone acetate (progestin) 1 mg daily] were recruited. Three-dimensional power Doppler angiography (3D-PDA) was performed before hormone treatment (phase 0), on days 10–11 of hormone treatment (phase E), and on days 18–20 of hormone treatment (phase E + P). Ishikawa EEC were treated with or without 17-β-estradiol and progesterone for 24 hours, followed by determination of VEGF concentrations in the supernatants.

Results

The endometrial volume was significantly increased in phase E and phase E + P as compared with that in phase 0. The vascularization index, flow index, and vascularization flow index in the subendometrial region, as measured by 3D-PDA, were significantly higher in phase E + P than in phase 0, but there were no significant differences in these indices between phase 0 and phase E. While treatment of EEC with 17-β-estradiol had little enhancing effect on VEGF production, progesterone alone or in combination with 17-β-estradiol significantly increased VEGF secretion from EEC.

Conclusion

Our data suggested that progesterone could stimulate VEGF secretion from EEC and subsequently increase subendometrial vascularity and blood flow.

Key Words:  endometrium , estrogen , hemodynamics , progesterone , ultrasonography

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PII: S1726-4901(09)70052-8

doi:10.1016/S1726-4901(09)70052-8

Journal of the Chinese Medical Association
Volume 72, Issue 4 , Pages 188-193, April 2009

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