Protective role of adrenomedullin in heterotopic ovarian transplant

Purpose of investigation: To study adrenomedullin (ADM) in preventing ischemia and morphological changes in heterotopically transplanted ovary. Materials and Methods: Forty female Sprague-Dawley rats were divided into four groups. In groups 1 and 2 each ovary was transplanted to the corresponding inguinal region by heterotopic transplantation. In groups 3 and 4, ovaries were left intact without transplantation. Treatment was injected to left inguinal region. ADM was given in groups 1 and 3 and placebo was given in groups 2 and 4. Left ovaries showing local treatment effect in heterotopic transplantation was designated as A (1A, 2A, 3A, and 4A), right ovaries showing systemic treatment effect were designated as (1B, 2B,3B, and 4B). Main outcome measures were ischemia, follicle count, and CD 31 expression. Results: Ovaries treated with local ADM (group 1A) were in consonance with normal rat ovaries. The ovaries of rats in group 1B and placebo treated transplant group (groups 2A, 2B) exhibited varying effects of ischemia. The mean follicle numbers in groups 1A, 1B, 2A, 2B were 28 3.3, 16.8 2.5, 17.7 2.1, 16.4 2.9, respectively. The mean follicle number in groups 3A, 3B, 4A, and 4B were 27.7 2.0, 28.3 2.2, 28.3 2.2, 27.8 1.9, respectively. Corpus luteum number and CD31 expression was found to be significantly higher in group 1A. Conclusion: Subcutaneous injection of ADM to heterotopic ovarian graft site causes vasodilatation and increases angiogenesis and may protect ovarian graft against hypoxic damage.