Smoking reduces ovarian stromal blood flow in polycystic ovary syndrome patients

Ginekol Pol. 2020;91(4):201-206. doi: 10.5603/GP.2020.0041.


Objectives: The objective of the current research is to compare hormonal, metabolic and ovarian stromal blood flow outcomes in smoking versus non-smoking polycystic ovary syndrome (PCOS) patients.

Material and methods: 79 PCOS women (Group 1) and 79 healthy subjects (Group 2) were recruited. Both groups were subdivided according to their smoking habits. Ovarian stromal blood flow was assessed with pulsatility and resistance index for both ovaries and compared among smoking women.

Results: The smokers in the PCOS group had statistically significant higher levels of pulsatility and resistance index in both ovaries compared to nonsmoker PCOS patients (p < 0.001). Comparison of ovarian stromal blood flow indexes shows that pulsatility and resistance index for both ovaries is statistically significantly high in smoking healthy patients compared to the nonsmoking group (p < 0.001). There is a positive correlation between smoking and free androgen index (r = 0.866, p < 0.001) for PCOS patients and healthy women.

Conclusions: Smoking reduces ovarian blood flow in PCOS patients and healthy subjects. Smoke components effect the vascular structure and form endothelial injuries that may reduce ovarian tissue perfusion. In this study, the positive correlation between smoking and free androgen index shows that the main effect of smoking on ovarian blood flow may be through androgen metabolism.

Keywords: cardiovascular risk; ovarian stromal doppler; polycystic ovary syndrome; pulsatility index; resistance index; smoking.

MeSH terms

  • Adult
  • Blood Flow Velocity
  • Case-Control Studies
  • Female
  • Follicle Stimulating Hormone / blood
  • Humans
  • Ovary / blood supply
  • Polycystic Ovary Syndrome / blood*
  • Polycystic Ovary Syndrome / physiopathology*
  • Smoking / adverse effects*
  • Stromal Cells / pathology*
  • Testosterone / blood
  • Ultrasonography, Doppler, Color
  • Young Adult


  • Testosterone
  • Follicle Stimulating Hormone