Atorvastatin for Ovarian Torsion: Effects on Follicle Counts, AMH, and VEGF Expression

Abstract

Objective(s): To determine if atorvastatin protects ovarian follicles against ischemia reperfusion (I/R) injury and to determine how anti-Mullerian hormone (AMH) and vascular endothelial growth factor-A (VEGF-A) expression is altered.

Study design: This experimental study was conducted at the Baskent University Animal Research Laboratory. Forty-four rats were arbitrarily assigned into four groups of 11 rats each. The control group underwent a laparotomy. The atorvastatin group received atorvastatin (10 mg/kg/day), by oral gavage 7 days before and 7 days after the sham operation. The torsion group had bilateral torsion and detorsion of the ovaries. The atorvastatin + torsion group received atorvastatin (10 mg/kg/day) 7 days before and 7 days after the torsion/detorsion operation. At day 7, the animals were euthanized and their ovaries were removed. Ovarian follicles were counted, and AMH and VEGF-A expression was determined. The Kruskal-Wallis, chi(2), or Fisher's exact test were used when appropriate.

Results: Primordial follicles (p = 0.001), VEGF-A expression (p = 0.018) and vascularization (p = 0.02) were significantly higher in the atorvastatin group compared to controls. Primordial (p = 0.002), primary (p = 0.001), and secondary follicles (p = 0.001), AMH expression (p = 0.001), and vascularization (p = 0.001) were lower in the torsion group compared with the control group. Primordial follicles (p = 0.001), AMH (p = 0.001) and VEGFA expression (p = 0.001), and vascularization (p = 0.001) were significantly higher in the atorvastatin + torsion group compared to the torsion group.

Conclusion(s): Atorvastatin increased the primordial follicle pool and vascularization and protected primordial follicles and vascular structures against I/R injury. (C) 2014 Elsevier Ireland Ltd. All rights reserved.