Vascular endothelial growth factor expression in the endometrium during the menstrual cycle, implantation window and...

The review aims to summarize recent data about vascular endothelial growth factor and its implications in the normal endometrium during the menstrual cycle, implantation window and early pregnancy.

Angiogenesis is crucial for the development of endometrium as well as for embryo implantation and establishment of pregnancy. A number of cytokines and growth factors including vascular endothelial growth factor are known to modulate angiogenesis in human endometrium in vitro and in vivo. Intrauterine vascular endothelial growth factor expression has been shown to be regulated in a cycle-dependent fashion. Recent studies have demonstrated that female sex steroid hormones and gonadotrophins contribute to the regulation of vascular endothelial growth factor by endometrial glandular epithelial and stromal cells. Vascular endothelial growth factor levels increase around the peri-implantation period and in the late secretory and pre-menstrual phases. Further, the production of this angiogenic growth factor appears to be related to decidualization.

Vascular endothelial growth factor is a key regulator of angiogenesis and vascular function in the human endometrium. Aberrant endometrial angiogenesis may result in menstrual dysfunction, failed implantation and first-trimester miscarriage. The possibility of enhancing or inhibiting angiogenic activity in the endometrium will provide a novel approach to the manipulation of reproductive functions.