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-Müllerian 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, χ2 , 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.