Importance of angiogenesis in reproductive physiology

The cyclic angiogenesis that occurs uniquely within the female reproductive tract is critical for normal reproduction. Two families of endothelial cell-specific growth factors and their receptors have been identified in the ovary, uterus, and placenta: vascular endothelial growth factor/vascular permeability factor and the angiopoietins. These appear to have complementary actions on the vasculature and to be involved during intrauterine development as well as in the adult. Within the ovary, a complex cascade of events required for angiogenesis may play a role in follicular maturation and selection as well as in normal corpus luteum function. Aberrant expression of angiogenic factors plays a role in a wide variety of abnormalities in the ovary. In the uterus, angiogenesis is required for endometrial growth and remodeling. Peptide growth factors such as vascular endothelial growth factor may serve as local mediators of the effects of reproductive hormones on the endometrial vasculature. Disease states such as dysfunctional uterine bleeding, endometriosis, and endometrial hyperplasia or cancer may be associated with aberrant uterine angiogenesis.