Skip to main content
Top
Published in: Reproductive Biology and Endocrinology 1/2020

01-12-2020 | Infertility | Research

The effect of different estradiol levels on carotid artery distensibility during a long agonist IVF protocol

Authors: Jonna Leppänen, Kaisa Randell, Ursula Schwab, Jussi Pihlajamäki, Leea Keski-Nisula, Tomi Laitinen, Seppo Heinonen

Published in: Reproductive Biology and Endocrinology | Issue 1/2020

Login to get access

Abstract

Background

This study was made to figure out, does low and high estradiol levels during in vitro fertilization (IVF) cycles have a different effect on carotid artery distensibility (Cdis), carotid artery diameter (Cdia), blood pressure and metabolic factors? Can the stimulation protocol be considered safe to women’s vasculature?

Methods

We studied 28 women having a long agonist protocol IVF-treatment in Kuopio University Hospital during the years 2011–2016. Patients were examined at three time points: in the beginning of their own period (low estradiol), during the gonadotrophin releasing hormone (GnRH) analogue downregulation (low estradiol) and during the follicle stimulating hormone (FSH) stimulation (high estradiol). Women served as their own controls and their menstrual phase (2- to 5-day period after the beginning of menstruation with low estrogen) was used as the reference. Cdis and Cdia were assessed using ultrasound. Blood pressure, weight, estradiol levels and lipids were monitored.

Results

Cdis, Cdia, systolic and diastolic blood pressures peaked during the GnRH-analogue treatment with the lowest estradiol levels. Cdis, Cdia and systolic blood pressures declined by 11% (P = 0.002), 3,8% (P < 0.001) and 2,5% (P = 0.026) during the FSH-stimulation when the estradiol levels were high. Cdis correlated significantly (P < 0.05) with systolic blood pressure, diastolic blood pressure and triglycerides in high estrogenic environment and with diastolic blood pressure (P < 0.05) when estrogen profiles were low.

Conclusions

Carotid artery stiffens during the high estradiol levels compared to low levels and this was not explained by the higher diameter of the carotid artery, hyperlipidemia or blood pressure profiles. All the changes in Cdis and Cdia are variations of normal, and if there is no history of cardiovascular problems, it can be considered, that the stimulation protocol is not hazardous to vasculature.
Literature
1.
go back to reference Hayashi K, Miyachi M, Seno N, Takahashi K, Yamazaki K, Sugawara J, et al. Fluctuations in carotid arterial distensibility during the menstrual cycle do not influence cardiovagal baroreflex sensitivity. Acta Physiol (Oxf). 2006;186(2):103–10.CrossRef Hayashi K, Miyachi M, Seno N, Takahashi K, Yamazaki K, Sugawara J, et al. Fluctuations in carotid arterial distensibility during the menstrual cycle do not influence cardiovagal baroreflex sensitivity. Acta Physiol (Oxf). 2006;186(2):103–10.CrossRef
2.
go back to reference Fritz M, Speroff L, editors. Chapter 8. The Endocrinology of Pregnancy. In: Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia: Lippincott, Williams & Wilkins; 2011. p. 276. Fritz M, Speroff L, editors. Chapter 8. The Endocrinology of Pregnancy. In: Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia: Lippincott, Williams & Wilkins; 2011. p. 276.
3.
go back to reference Kärkkäinen H, Saarelainen H, Valtonen P, Laitinen T, Raitakari OT, Juonala M, et al. Carotid artery elasticity decreases during pregnancy - the Cardiovascular Risk in Young Finns study. BMC Pregnancy Childbirth. 2014;14:98.PubMedPubMedCentralCrossRef Kärkkäinen H, Saarelainen H, Valtonen P, Laitinen T, Raitakari OT, Juonala M, et al. Carotid artery elasticity decreases during pregnancy - the Cardiovascular Risk in Young Finns study. BMC Pregnancy Childbirth. 2014;14:98.PubMedPubMedCentralCrossRef
4.
go back to reference Mersich B, Rigo J, Besenyei C, Lenard Z, Studinger P, Kollai M. Opposite changes in carotid versus aortic stiffness during healthy human pregnancy. Clin Sci (Lond). 2005;109(1):103–7.CrossRef Mersich B, Rigo J, Besenyei C, Lenard Z, Studinger P, Kollai M. Opposite changes in carotid versus aortic stiffness during healthy human pregnancy. Clin Sci (Lond). 2005;109(1):103–7.CrossRef
5.
go back to reference Fritz M, Speroff L, editors. Chapter 17. Menopause and Perimenopausal Transition. In: Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia: Lippincott, Williams & Wilkins; 2011. p. 690. Fritz M, Speroff L, editors. Chapter 17. Menopause and Perimenopausal Transition. In: Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia: Lippincott, Williams & Wilkins; 2011. p. 690.
6.
go back to reference Bui MN, Arai AE, Hathaway L, Waclawiw MA, Csako G, Cannon RO. Effect of hormone replacement therapy on carotid arterial compliance in healthy postmenopausal women. Am J Cardiol. 2002;90(1):82–5.PubMedCrossRef Bui MN, Arai AE, Hathaway L, Waclawiw MA, Csako G, Cannon RO. Effect of hormone replacement therapy on carotid arterial compliance in healthy postmenopausal women. Am J Cardiol. 2002;90(1):82–5.PubMedCrossRef
7.
go back to reference Juonala M, Järvisalo MJ, Mäki-Torkko N, Kähonen M, Viikari JS, Raitakari OT. Risk factors identified in childhood and decreased carotid artery elasticity in adulthood: the cardiovascular risk in young Finns study. Circulation. 2005;112(10):1486–93.PubMedCrossRef Juonala M, Järvisalo MJ, Mäki-Torkko N, Kähonen M, Viikari JS, Raitakari OT. Risk factors identified in childhood and decreased carotid artery elasticity in adulthood: the cardiovascular risk in young Finns study. Circulation. 2005;112(10):1486–93.PubMedCrossRef
8.
go back to reference Hirai T, Sasayama S, Kawasaki T, Yagi S. Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis. Circulation. 1989;80(1):78–86.PubMedCrossRef Hirai T, Sasayama S, Kawasaki T, Yagi S. Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary atherosclerosis. Circulation. 1989;80(1):78–86.PubMedCrossRef
9.
go back to reference Visontai Z, Lenard Z, Studinger P, Rigo J, Kollai M. Impaired baroreflex function during pregnancy is associated with stiffening of the carotid artery. Ultrasound Obstet Gynecol. 2002;20(4):364–9.PubMedCrossRef Visontai Z, Lenard Z, Studinger P, Rigo J, Kollai M. Impaired baroreflex function during pregnancy is associated with stiffening of the carotid artery. Ultrasound Obstet Gynecol. 2002;20(4):364–9.PubMedCrossRef
10.
go back to reference Vaidya D, Golden SH, Haq N, Heckbert SR, Liu K, Ouyang P. Association of sex hormones with carotid artery distensibility in men and postmenopausal women: multi-ethnic study of atherosclerosis. Hypertension. 2015;65(5):1020–5.PubMedPubMedCentralCrossRef Vaidya D, Golden SH, Haq N, Heckbert SR, Liu K, Ouyang P. Association of sex hormones with carotid artery distensibility in men and postmenopausal women: multi-ethnic study of atherosclerosis. Hypertension. 2015;65(5):1020–5.PubMedPubMedCentralCrossRef
11.
go back to reference Westendorp IC, Bots ML, Grobbee DE, Reneman RS, Hoeks AP, Van Popele NM, et al. Menopausal status and distensibility of the common carotid artery. Arterioscler Thromb Vasc Biol. 1999;19(3):713–7.PubMedCrossRef Westendorp IC, Bots ML, Grobbee DE, Reneman RS, Hoeks AP, Van Popele NM, et al. Menopausal status and distensibility of the common carotid artery. Arterioscler Thromb Vasc Biol. 1999;19(3):713–7.PubMedCrossRef
12.
go back to reference Rajkumar C, Kingwell BA, Cameron JD, Waddell T, Mehra R, Christophidis N, et al. Hormonal therapy increases arterial compliance in postmenopausal women. J Am Coll Cardiol. 1997;30(2):350–6.PubMedCrossRef Rajkumar C, Kingwell BA, Cameron JD, Waddell T, Mehra R, Christophidis N, et al. Hormonal therapy increases arterial compliance in postmenopausal women. J Am Coll Cardiol. 1997;30(2):350–6.PubMedCrossRef
13.
go back to reference Nagai Y, Earley CJ, Kemper MK, Bacal CS, Metter EJ. Influence of age and postmenopausal estrogen replacement therapy on carotid arterial stiffness in women. Cardiovasc Res. 1999;41(1):307–11.PubMedCrossRef Nagai Y, Earley CJ, Kemper MK, Bacal CS, Metter EJ. Influence of age and postmenopausal estrogen replacement therapy on carotid arterial stiffness in women. Cardiovasc Res. 1999;41(1):307–11.PubMedCrossRef
14.
go back to reference Angerer P, Kothny W, Stork S, von Schacky C. Hormone replacement therapy and distensibility of carotid arteries in postmenopausal women: a randomized, controlled trial. J Am Coll Cardiol. 2000;36(6):1789–96.PubMedCrossRef Angerer P, Kothny W, Stork S, von Schacky C. Hormone replacement therapy and distensibility of carotid arteries in postmenopausal women: a randomized, controlled trial. J Am Coll Cardiol. 2000;36(6):1789–96.PubMedCrossRef
15.
go back to reference Westendorp IC, de Kleijn MJ, Bots ML, Bak AA, Planellas J, Coelingh Bennink HJ, et al. The effect of hormone replacement therapy on arterial distensibility and compliance in perimenopausal women: a 2-year randomised trial. Atherosclerosis. 2000;152(1):149–57.PubMedCrossRef Westendorp IC, de Kleijn MJ, Bots ML, Bak AA, Planellas J, Coelingh Bennink HJ, et al. The effect of hormone replacement therapy on arterial distensibility and compliance in perimenopausal women: a 2-year randomised trial. Atherosclerosis. 2000;152(1):149–57.PubMedCrossRef
16.
go back to reference Yang EY, Chambless L, Sharrett AR, Virani SS, Liu X, Tang Z, et al. Carotid arterial wall characteristics are associated with incident ischemic stroke but not coronary heart disease in the atherosclerosis risk in communities (ARIC) study. Stroke. 2012;43(1):103–8.PubMedCrossRef Yang EY, Chambless L, Sharrett AR, Virani SS, Liu X, Tang Z, et al. Carotid arterial wall characteristics are associated with incident ischemic stroke but not coronary heart disease in the atherosclerosis risk in communities (ARIC) study. Stroke. 2012;43(1):103–8.PubMedCrossRef
17.
go back to reference Mattsson N, Ronnemaa T, Juonala M, Viikari JS, Jokinen E, Hutri-Kahonen N, et al. Arterial structure and function in young adults with the metabolic syndrome: the cardiovascular risk in young Finns study. Eur Heart J. 2008;29(6):784–91.PubMedCrossRef Mattsson N, Ronnemaa T, Juonala M, Viikari JS, Jokinen E, Hutri-Kahonen N, et al. Arterial structure and function in young adults with the metabolic syndrome: the cardiovascular risk in young Finns study. Eur Heart J. 2008;29(6):784–91.PubMedCrossRef
18.
go back to reference Ward MR, Pasterkamp G, Yeung AC, Borst C. Arterial remodeling. Mechanisms and clinical implications. Circulation. 2000;102(10):1186–91.PubMedCrossRef Ward MR, Pasterkamp G, Yeung AC, Borst C. Arterial remodeling. Mechanisms and clinical implications. Circulation. 2000;102(10):1186–91.PubMedCrossRef
19.
go back to reference Benjamin EJ, Larson MG, Keyes MJ, Mitchell GF, Vasan RS, Keaney JF, et al. Clinical correlates and heritability of flow-mediated dilation in the community: the Framingham heart study. Circulation. 2004;109(5):613–9.PubMedCrossRef Benjamin EJ, Larson MG, Keyes MJ, Mitchell GF, Vasan RS, Keaney JF, et al. Clinical correlates and heritability of flow-mediated dilation in the community: the Framingham heart study. Circulation. 2004;109(5):613–9.PubMedCrossRef
20.
go back to reference Sugawara J, Otsuki T, Maeda S, Tanabe T, Kuno S, Ajisaka R, et al. Effect of arterial lumen enlargement on carotid arterial compliance in normotensive postmenopausal women. Hypertens Res. 2005;28(4):323–9.PubMedCrossRef Sugawara J, Otsuki T, Maeda S, Tanabe T, Kuno S, Ajisaka R, et al. Effect of arterial lumen enlargement on carotid arterial compliance in normotensive postmenopausal women. Hypertens Res. 2005;28(4):323–9.PubMedCrossRef
21.
go back to reference Staessen JA. Van der Heijden-Spek, J J, Safar ME, Den Hond E, Gasowski J, Fagard RH, et al. menopause and the characteristics of the large arteries in a population study. J Hum Hypertens. 2001;15(8):511–8.PubMedCrossRef Staessen JA. Van der Heijden-Spek, J J, Safar ME, Den Hond E, Gasowski J, Fagard RH, et al. menopause and the characteristics of the large arteries in a population study. J Hum Hypertens. 2001;15(8):511–8.PubMedCrossRef
22.
go back to reference Mercuro G, Zoncu S, Pilia I, Lao A, Melis GB, Cherchi A. Effects of acute administration of transdermal estrogen on postmenopausal women with systemic hypertension. Am J Cardiol. 1997;80(5):652–5.PubMedCrossRef Mercuro G, Zoncu S, Pilia I, Lao A, Melis GB, Cherchi A. Effects of acute administration of transdermal estrogen on postmenopausal women with systemic hypertension. Am J Cardiol. 1997;80(5):652–5.PubMedCrossRef
23.
go back to reference Harvey PJ, Wing LM, Savage J, Molloy D. The effects of different types and doses of oestrogen replacement therapy on clinic and ambulatory blood pressure and the renin-angiotensin system in normotensive postmenopausal women. J Hypertens. 1999;17(3):405–11.PubMedCrossRef Harvey PJ, Wing LM, Savage J, Molloy D. The effects of different types and doses of oestrogen replacement therapy on clinic and ambulatory blood pressure and the renin-angiotensin system in normotensive postmenopausal women. J Hypertens. 1999;17(3):405–11.PubMedCrossRef
24.
go back to reference Seely EW, Walsh BW, Gerhard MD, Williams GH. Estradiol with or without progesterone and ambulatory blood pressure in postmenopausal women. Hypertension. 1999;33(5):1190–4.PubMedCrossRef Seely EW, Walsh BW, Gerhard MD, Williams GH. Estradiol with or without progesterone and ambulatory blood pressure in postmenopausal women. Hypertension. 1999;33(5):1190–4.PubMedCrossRef
Metadata
Title
The effect of different estradiol levels on carotid artery distensibility during a long agonist IVF protocol
Authors
Jonna Leppänen
Kaisa Randell
Ursula Schwab
Jussi Pihlajamäki
Leea Keski-Nisula
Tomi Laitinen
Seppo Heinonen
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Reproductive Biology and Endocrinology / Issue 1/2020
Electronic ISSN: 1477-7827
DOI
https://doi.org/10.1186/s12958-020-00608-w

Other articles of this Issue 1/2020

Reproductive Biology and Endocrinology 1/2020 Go to the issue