von Wowern Emma, Saldeen Pia, Olofsson Per
a Department of Obstetrics and Gynecology, Skåne University Hospital, Institution of Clinical Sciences Malmö , Lund University , Malmö , Sweden.
b Nordic IVF Malmö, Institution of Clinical Sciences Malmö , Lund University , Malmö , Sweden.
Hypertens Pregnancy. 2018 Nov;37(4):182-191. doi: 10.1080/10641955.2018.1516225. Epub 2018 Sep 21.
Female sex hormones have vasorelaxing effects in non-pregnant and pregnant women. We aimed to investigate the effect of controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF), and early pregnancy, on arterial stiffness as assessed by digital pulse wave analysis (DPA), hypothesizing reduced arterial stiffness as an effect of increased estrogen levels.
A total of 68 women undergoing IVF were examined with DPA before conception and during IVF treatment with COH and embryo transfer (ET), and in gestational week seven in 19 women who became pregnant. Heart rate (HR), mean arterial pressure (MAP) and the DPA variables cardiac ejection elasticity index (EEI), b/a, dicrotic index (DI), d/a and aging index (AI) were measured.
HR was significantly increased at all measuring points (p ≤ 0.003) but MAP only at ET (p 0.007). DPA variables representing large arteries (EEI, b/a) and peripheral arteries (DI, but not d/a), and the global variable AI, indicated increased arterial stiffness at ET compared with baseline (p ≤ 0.035). No DPA variable was significantly changed at pregnancy measurements compared to baseline.
During COH for IVF treatment, DPA showed no changes in arterial stiffness during the follicular phase or in early pregnancy, but increased arterial stiffness in central and peripheral arteries in the early luteal phase. The result suggests a hormonal hemodynamic activation counteracting the effects of estrogen.
女性性激素对非孕期和孕期女性具有血管舒张作用。我们旨在研究体外受精（IVF）过程中控制性卵巢刺激（COH）以及早期妊娠对动脉僵硬度的影响，通过数字脉搏波分析（DPA）进行评估，假设雌激素水平升高会降低动脉僵硬度。
共有68名接受IVF的女性在受孕前、接受COH和胚胎移植（ET）的IVF治疗期间以及19名成功怀孕女性的妊娠第7周接受了DPA检查。测量心率（HR）、平均动脉压（MAP）以及DPA变量心脏射血弹性指数（EEI）、b/a、重搏波指数（DI）、d/a和衰老指数（AI）。
所有测量点的HR均显著升高（p≤0.003），但MAP仅在ET时升高（p = 0.007）。代表大动脉（EEI、b/a）和外周动脉（DI，但不包括d/a）的DPA变量以及整体变量AI显示，与基线相比，ET时动脉僵硬度增加（p≤0.035）。与基线相比，妊娠测量时DPA变量无显著变化。
在IVF治疗的COH期间，DPA显示卵泡期或早期妊娠时动脉僵硬度无变化，但在黄体早期中央和外周动脉的动脉僵硬度增加。结果表明激素性血流动力学激活抵消了雌激素的作用。
