, Volume 8, Issue 2, pp 89–99 | Cite as

Recent advances in endometrial angiogenesis research

  • Jane E. GirlingEmail author
  • Peter A.W. Rogers


This review summarises recent research into the mechanisms and regulation of endometrial angiogenesis. Understanding of when and by what mechanisms angiogenesis occurs during the menstrual cycle is limited, as is knowledge of how it is regulated. Significant endometrial endothelial cell proliferation occurs at all stages of the menstrual cycle in humans, unlike most animal models where a more precise spatial relationship exists between endothelial cell proliferation and circulating levels of oestrogen and progesterone. Recent stereological data has identified vessel elongation as a major endometrial angiogenic mechanism in the mid-late proliferative phase of the cycle. In contrast, the mechanisms that contribute to post-menstrual repair and secretory phase remodelling have not yet been determined. Both oestrogen and progesterone/progestins appear to have paradoxical actions, with recent studies showing that under different circumstances both can promote as well as inhibit endometrial angiogenesis. The relative contribution of direct versus indirect effects of these hormones on the vasculature may help to explain their pro- or anti-angiogenic activities. Recent work has also identified the hormone relaxin as a player in the regulation of endometrial angiogenesis. While vascular endothelial growth factor (VEGF) is fundamental to endometrial angiogenesis, details of how and when different endometrial cell types produce VEGF, and how production and activity is controlled by oestrogen and progesterone, remains to be elucidated. Evidence is emerging that the different splice variants of VEGF play a major role in regulating endometrial angiogenesis at a local level. Intravascular neutrophils containing VEGF have been identified as having a role in stimulating endometrial angiogenesis, although other currently unidentified mechanisms must also exist. Future studies to clarify how endometrial angiogenesis is regulated in the human, as well as in relevant animal models, will be important for a better understanding of diseases such as breakthrough bleeding, menorrhagia, endometriosis and endometrial cancer.


angiogenesis endometrium endothelial cell human menstrual cycle neutrophil oestrogen progesterone VEGF 



basic fibroblast growth factor


oestrogen receptor




vessel length density


average vessel length per branch point




medroxyprogesterone acetate


membrane type metalloproteinase


vessel branch point density




progesterone receptor


tumour necrosis factor-α


urokinase-type plasminogen activator


vascular endothelial growth factor


vascular endothelial growth factor receptor


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This work was supported by the National Health and Medical Research Council project grant #124331 to PR. PR’s salary is provided by NH&MRC Fellowship grant #143805.


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Copyright information

© Springer Science+Business Media Inc. 2005

Authors and Affiliations

  1. 1.Centre for Women’s Health ResearchMonash University Department of Obstetrics and Gynaecology, Monash Medical CentreClaytonAustralia

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