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Lazareva L, Suturina L, Atalyan A, Danusevich I, Nadelyaeva I, Belenkaya L, Egorova I, Ievleva K, Babaeva N, Lizneva D, Legro RS, Azziz R. Ovarian Morphology in Non-Hirsute, Normo-Androgenic, Eumenorrheic Premenopausal Women from a Multi-Ethnic Unselected Siberian Population. Diagnostics (Basel) 2024; 14:673. [PMID: 38611586 PMCID: PMC11012196 DOI: 10.3390/diagnostics14070673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is a highly prevalent disorder in women, and its diagnosis rests on three principal features: ovulatory/menstrual dysfunction, clinical and/or biochemical hyperandrogenism, and polycystic ovarian morphology (PCOM). Currently, data on age- and ethnicity-dependent features of PCOM remain insufficient. We aimed to estimate ethnicity- and age-dependent differences in ovarian volume (OV) and follicle number per ovary (FNPO) in a healthy, medically unbiased population of Caucasian and Asian premenopausal women, who participated in the cross-sectional Eastern Siberia PCOS epidemiology and phenotype (ESPEP) study (ClinicalTrials.gov ID: NCT05194384) in 2016-2019. The study population consisted of 408 non-hirsute, normo-androgenic, eumenorrheic premenopausal women aged 18-44 years. All participants underwent a uniform evaluation including a review of their medical history and a physical examination, blood sampling, and pelvic ultrasonography. The statistical analysis included non-parametric tests and the estimation of the upper normal limits (UNLs) by 98th percentiles for OV and FNPO. In the total study population, the upper OV percentiles did not differ by ethnicity or age group. By contrast, the UNL of FNPO was higher in Caucasian women than in Asian women, and women aged <35 years demonstrated a higher UNL of FNPO compared to older women. In summary, these data suggest that the estimation of FNPO, but not OV, should take into account the ethnicity and age of the individual in estimating the presence of PCOM.
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Affiliation(s)
- Ludmila Lazareva
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Larisa Suturina
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Alina Atalyan
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Irina Danusevich
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Iana Nadelyaeva
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Lilia Belenkaya
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Irina Egorova
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Kseniia Ievleva
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Natalia Babaeva
- Scientific Center for Family Health and Human Reproduction Problems, 664003 Irkutsk, Russia
| | - Daria Lizneva
- Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Richard S. Legro
- Penn State College of Medicine, Penn State University, Hershey, PA 17033, USA
| | - Ricardo Azziz
- Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Mondal S, Gargari P, Nagendra L, Mandal S, Kumar RC, Shah P, Haldar M, Chowdhury S, Mukhopadhyay S. Growth hormone therapy is associated with improved uterine dimensions in girls with Turner syndrome prior to oestrogen replacement. Clin Endocrinol (Oxf) 2024; 100:66-75. [PMID: 37555570 DOI: 10.1111/cen.14957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Adult women with Turner syndrome (TS) have high rates of miscarriage, presumably due to the abnormal size and shape of the uterus. There is a paucity of data regarding the determinants of uterine volume (UtVol) in young girls with TS before the initiation of oestrogen replacement therapy (ERT). METHODS We performed a cross-sectional study on premenarchal girls with TS, aged 5-15 years, pubertal stage B1-B3, not having received ERT (n = 73) and 50 age-matched healthy controls. Anthropometric parameters and a history of growth hormone (GH) therapy (≥1 year) were noted. Uterine length (UtL), UtVol, and mean-ovarian-volume (MOV) standard-deviation scores (SDS) were determined from transabdominal ultrasonography data. RESULTS Girls with TS had lower median UtVol-SDS (-1.07 vs. 0.86; p < .001), UtL-SDS (-3.72 vs. -0.41; p < .001) and MOV-SDS (-5.53 vs. 1.96; p < .001) compared to age-matched controls. Among TS girls, recipients of GH (n = 38) had higher UtVol-SDS (-0.63 vs. -1.39; p = .0001), UtL-SDS (-1.73 vs. -6.49; p < .0001) but similar MOV-SDS compared to nonrecipients (n = 35). Those with normal uterine volume for age (NUVA, n = 29) had earlier initiation (7.8 vs. 9.3 years; p = .03) and a longer duration of GH (3.71 vs. 2.14 years; p = .002) than those with low UtVol for age (n = 44). UtVol-SDS correlated with duration of GH (ρ = 0.411, p = .01) and negatively with age at GH initiation (ρ = -0.479, p = .003). In a model adjusted for pubertal status, karyotype and height-SDS, GH use could independently predict having NUVA (odds ratio: 5.09, confidence interval: 1.63-15.94, p = .005). CONCLUSION GH therapy has a stimulatory effect on uterine dimensions in pre-and peripubertal girls with TS. Earlier initiation and longer duration of GH is important in TS girls before ERT.
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Affiliation(s)
- Sunetra Mondal
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Piyas Gargari
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Lakshmi Nagendra
- Department of Endocrinology, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Santanu Mandal
- Department of Radiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Rathin C Kumar
- Department of Radiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Pooja Shah
- Department of Radiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | | | - Subhankar Chowdhury
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Satinath Mukhopadhyay
- Department of Endocrinology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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Wang S, Zhang M, Hu X, Duan N, Chen X, Yin Y, Wang Z. Diagnostic values of MRI indexes for polycystic ovary syndrome. Acta Radiol 2023; 64:806-813. [PMID: 35188811 DOI: 10.1177/02841851221080521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is a useful non-invasive modality for observation of ovarian morphologic characteristics. Few studies have focused on the value of MRI-derived indexes in reproductive-aged women with polycystic ovary syndrome (PCOS). PURPOSE To assess the diagnostic value of MRI in women with PCOS. MATERIAL AND METHODS This prospective case-control study included 85 women with PCOS and 50 controls who underwent pelvic MRI during 2017-2019. Ovarian volume (OV), follicle count (FC; counts of follicles sizing 2-3, 4-6, 7-9, 2-9 mm, respectively), follicular peripheral distribution, absence of a dominant follicle and stromal to total area ratio (S:A) were determined with MRI. The diagnostic value (sensitivity, specificity, area under the receiver operating characteristic curve [AUC]) of OV, FC2-9, and follicular peripheral distribution for PCOS were assessed. RESULTS The AUCs were 0.94 for OV, 0.96 for FC2-9, and 0.78 for follicular peripheral distribution. The optimal threshold to detect PCOS was 8.5 mL for OV (sensitivity 78%; specificity 96%) and 26 for FC2-9 (sensitivity 85%; specificity 98%). Sensitivity and specificity were 73% and 82% for follicular peripheral distribution, respectively. Reproducibility was perfect for OV (ICC = 0.96) and absence of a dominant follicle (k = 0.85), substantial for FC2-9 (ICC = 0.79) and S:A (ICC = 0.69), and moderate for follicular peripheral distribution (k = 0.56). CONCLUSION Detected by MRI, OV >8.5 mL or FC2-9 >26 are accurate for diagnosing PCOS.
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Affiliation(s)
- Shaojuan Wang
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Meimei Zhang
- Departments of Ultrasonography, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Xuyu Hu
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Na Duan
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Xiao Chen
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Yanyun Yin
- Departments of Gynecology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, PR China
| | - Zhongqiu Wang
- Department of Radiology, 375808Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, PR China
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Vanden Brink H, Jarrett BY, Pereira N, Spandorfer SD, Hoeger KM, Lujan ME. Diagnostic Performance of Ovarian Morphology on Ultrasonography across Anovulatory Conditions-Impact of Body Mass Index. Diagnostics (Basel) 2023; 13:diagnostics13030374. [PMID: 36766481 PMCID: PMC9914229 DOI: 10.3390/diagnostics13030374] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
The study objectives were to determine whether ovarian morphology can distinguish between women with regular menstrual cycles, normo-androgenic anovulation (NA-Anov), and PCOS and whether body mass index (BMI)-specific thresholds improved diagnostic potential. Women with PCOS (biochemical and/or clinical hyperandrogenism and irregular cycles; N = 66), NA-Anov (irregular cycles without clinical and/or biochemical hyperandrogenism; N = 64), or regular cycles (controls; cycles every 21-35 days in the absence of clinical or biochemical hyperandrogenism; N = 51) were evaluated. Participants underwent a reproductive history, physical exam, transvaginal ultrasound, and a fasting blood sample. Linear regression analyses were used to assess the impact of BMI on ovarian morphology across groups. The diagnostic performance of ovarian morphology for anovulatory conditions, and by BMI (lean: <25 kg/m2; overweight: ≥25 kg/m2), was tested using Receiver Operating Characteristic (ROC) curves. Follicle number per ovary (FNPO) and ovarian volume (OV), but not follicle number per cross-section (FNPS), increased across controls, NA-Anov, and PCOS. Overall, FNPO had the best diagnostic performance for PCOS versus controls (AUCROC = 0.815) and NA-Anov and controls (AUCROC = 0.704), and OV to differentiate between PCOS and NA-Anov (AUCROC = 0.698). In lean women, FNPO best differentiated between PCOS and controls (AUCROC = 0.843) and PCOS versus NA-Anov (AUCROC = 0.710). FNPS better distinguished between NA-Anov and controls (AUCROC = 0.687), although diagnostic performance was lower than when thresholds were generated using all participants. In women with overweight and obesity, OV persisted as the best diagnostic feature across all analyses (PCOS versus control, AUCROC = 0.885; PCOS versus NA-Anov, AUCROC = 0.673; NA-Anov versus controls, AUCROC = 0.754). Ovarian morphology holds diagnostic potential to distinguish between NA-Anov and PCOS, with marginal differences in diagnostic potential when participants were stratified by BMI suggesting that follicle number may provide better diagnostic performance in lean women and ovarian size in those with overweight.
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Affiliation(s)
- Heidi Vanden Brink
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA
- Department of Nutrition, Texas A&M University, College Station, TX 77840, USA
| | | | - Nigel Pereira
- Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Steven D. Spandorfer
- Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Kathy M. Hoeger
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY 14620, USA
| | - Marla E. Lujan
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA
- Correspondence:
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Mai PL, Miller A, Black A, Falk RT, Boggess JF, Tucker K, Stuckey AR, Rodriguez GC, Wong C, Amatruda TT, Wilkinson KJ, Modesitt SC, Yamada SD, Bixel KL, Glaser GE, Rose PG, Greene MH, Sherman ME. Effect of risk-reducing salpingo-oophorectomy on sex steroid hormone serum levels among postmenopausal women: an NRG Oncology/Gynecologic Oncology Group study. Am J Obstet Gynecol 2022; 227:61.e1-61.e18. [PMID: 35216968 DOI: 10.1016/j.ajog.2022.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Risk-reducing salpingo-oophorectomy is an effective ovarian cancer risk reduction strategy. However, bilateral oophorectomy has also been associated with increased long-term nonneoplastic sequelae, effects suggested to be mediated through reductions in systemic sex steroid hormone levels. Currently, it is unclear whether the postmenopausal ovary contributes to the systemic hormonal milieu or whether postmenopausal ovarian volume or other factors, such as body mass index and age, affect systemic hormone levels. OBJECTIVE We examined the impact of oophorectomy on sex steroid hormone levels in postmenopausal women. Furthermore, we explored how well ovarian volume measured by transvaginal ultrasound correlated with direct ovarian measures obtained during surgical pathology evaluation and investigated the association between hormone levels and ovarian volumes. STUDY DESIGN Postmenopausal women who underwent risk-reducing salpingo-oophorectomy (180 cases) or ovarian cancer screening (38 controls) enrolled in an international, prospective study of risk-reducing salpingo-oophorectomy and risk of ovarian cancer algorithm-based screening among women at increased risk of ovarian cancer (Gynecologic Oncology Group-0199) were included in this analysis. Controls were frequency matched to the cases on age at menopause, age at study entry, and time interval between blood draws. Ovarian volume was calculated using measurements obtained from transvaginal ultrasound in both cases and controls and measurements recorded in surgical pathology reports from cases. Serum hormone levels of testosterone, androstenedione, androstenediol, dihydrotestosterone, androsterone, dehydroepiandrosterone, estrone, estradiol, and sex hormone-binding globulin were measured at baseline and follow-up. Spearman correlation coefficients were used to compare ovarian volumes as measured on transvaginal ultrasound and pathology examinations. Correlations between ovarian volumes by transvaginal ultrasound and measured hormone levels were examined using linear regression models. All models were adjusted for age. Paired t tests were performed to evaluate individual differences in hormone levels before and after risk-reducing salpingo-oophorectomy. RESULTS Ovarian volumes measured by transvaginal ultrasound were only moderately correlated with those reported on pathology reports (Spearman rho [ρ]=0.42). The median time interval between risk-reducing salpingo-oophorectomy and follow-up for the cases was 13.3 months (range, 6.0-19.3), and the median time interval between baseline and follow-up for the controls was 12.7 months (range, 8.7-13.4). Sex steroid levels decreased with age but were not correlated with transvaginal ultrasound ovarian volume, body mass index, or time since menopause. Estradiol levels were significantly lower after risk-reducing salpingo-oophorectomy (percentage change, -61.9 post-risk-reducing salpingo-oophorectomy vs +15.2 in controls; P=.02), but no significant differences were seen for the other hormones. CONCLUSION Ovarian volumes measured by transvaginal ultrasound were moderately correlated with volumes directly measured on pathology specimens and were not correlated with sex steroid hormone levels in postmenopausal women. Estradiol was the only hormone that declined significantly after risk-reducing salpingo-oophorectomy. Thus, it remains unclear whether the limited post-risk-reducing salpingo-oophorectomy changes in sex steroid hormones among postmenopausal women impact long-term adverse outcomes.
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Affiliation(s)
- Phuong L Mai
- Center for Clinical Genetics and Genomics, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh Medical Center Magee-Womens Hospital, Pittsburgh, PA.
| | - Austin Miller
- NRG Oncology, Clinical Trial Development Division, Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Roni T Falk
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - John F Boggess
- Department of Obstetrics and Gynecology, The University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Katherine Tucker
- Hereditary Cancer Centre, Nelune Comprehensive Cancer Centre, Department of Medical Oncology, Prince of Wales Hospital and Community Health Services, Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
| | - Ashley R Stuckey
- Department of Obstetrics and Gynecology, Women & Infants Hospital, Providence, RI
| | - Gustavo C Rodriguez
- Division of Gynecologic Oncology, NorthShore University Health System, Evanston, IL
| | - Cheung Wong
- Division of Gynecologic Oncology, University of Vermont Medical Center, Burlington, VT
| | - Thomas T Amatruda
- Metro-Minnesota Community Oncology Research Consortium, Fridley Clinic, Fridley, MN
| | - Kelly J Wilkinson
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Susan C Modesitt
- Division of Gynecologic Oncology, University of Virginia Health, Charlottesville, VA
| | - S Diane Yamada
- Division of Gynecologic Oncology, The University of Chicago Medicine, Chicago, IL
| | - Kristin L Bixel
- Division of Gynecologic Oncology, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Peter G Rose
- Division of Gynecologic Oncology, Case Comprehensive Cancer Center, Cleveland Clinic, Cleveland, OH
| | - Mark H Greene
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
| | - Mark E Sherman
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL
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Pereira-Eshraghi CF, Tao R, Chiuzan CC, Zhang Y, Shen W, Lerner JP, Oberfield SE, Sopher AB. Ovarian follicle count by magnetic resonance imaging is greater in adolescents and young adults with polycystic ovary syndrome than in controls. F S Rep 2022; 3:102-109. [PMID: 35789714 PMCID: PMC9250127 DOI: 10.1016/j.xfre.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 01/19/2023] Open
Abstract
Objective To use magnetic resonance imaging (MRI) to quantify the follicle number per ovary (FNPO) using biplanar measurements and determine the ovarian volume (OV) using three-dimensional measurements in adolescents and young adults with polycystic ovary syndrome (PCOS) and controls and compare the differences between these groups; to examine the relationships between FNPO and OV and metabolic markers associated with PCOS; to compare OV obtained by use of MRI and ultrasound between young patients with PCOS and controls. Design Cross-sectional study. Setting Outpatient within a major medical center in New York City. Patients Adolescent girls and young women aged 13-25 years with PCOS (n = 16) and body mass index-, age-, and ethnicity-comparable control subjects (n = 15). Interventions None. Main Outcome Measures The OV and FNPO by use of MRI, OV by use of transabdominal pelvic ultrasound, anthropometric measurements, and biochemical and hormonal evaluation. Results The FNPO was higher in participants with PCOS (23.7 ± 4.6 follicles) than in controls (15.2 ± 4 follicles) when adjusted for menstrual age. The OV by use of ultrasound was higher in participants with PCOS (11.7 ± 5.6 mL) than in controls (8.1 ± 3.4 mL); however, OV by use of MRI did not differ between the groups. The OV by use of MRI and ultrasound correlated in participants with PCOS (r = 0.62) but not in controls. Conclusions Our results are in line with prior studies showing that FNPO may be a more sensitive measure of polycystic ovary morphology than OV. The results of this study support the use of ovarian k, a promising diagnostic tool for PCOS, in young patients.
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Affiliation(s)
- Camila Freitas Pereira-Eshraghi
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Rachel Tao
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Codruta C. Chiuzan
- Department of Biostatistics, Columbia University Irving Medical Center, New York, New York
| | - Yuan Zhang
- Department of Biostatistics, Columbia University Irving Medical Center, New York, New York
| | - Wei Shen
- Department of Pediatrics and Nutrition, New York Obesity Center, Columbia University Irving Medical Center, New York, New York
| | - Jodi P. Lerner
- Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York
| | - Sharon E. Oberfield
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York
| | - Aviva B. Sopher
- Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York,Reprint requests: Aviva B. Sopher, M.D., M.S., Division of Endocrinology, Diabetes and Metabolism, Department of Pediatrics, Columbia University Irving Medical Center, 622 West 168 Street, PH 17 West 308, New York, New York 10032.
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Topaloglu O, Evren B, Uzun M, Yologlu S, Guldogan E, Sahin I. Is there a Relationship between Serum IGF-1 and Thyroid Nodule, Thyroid or Ovarian Volume in Polycystic Ovarian Syndrome? Acta Endocrinol (Buchar) 2021; 17:138-146. [PMID: 34539923 DOI: 10.4183/aeb.2021.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Context Studies investigating the association between serum IGF-1, and thyroid nodule, ovarian or thyroid volume in polycystic ovarian syndrome (PCOS) are limited. Objective We aimed to analyze the association between serum IGF-1 level, and ovarian or thyroid volume, or thyroid nodule in PCOS. Design The study was performed between June 2017 and August 2019 as prospective design. Subjects and Methods Adult females with new-onset PCOS were included. The patients having comorbid illness, or using medication were excluded. Basic tests, thyroid and ovarian sonography were performed. The patients were grouped according to thyroid nodule(absent/present) and ovarian volume (<10mL/≥10mL). We planned to find a positive association between IGF-1, and thyroid nodule, thyroid or ovarian volume in PCOS. Results Of total 118 patients, 11(9%) had thyroid nodule. The patients with thyroid nodule had a higher ovarian volume (p=0.006). No correlation was found between GH or IGF-1, and thyroid or ovarian volume. IGF-1 was not a predictor for thyroid nodule or higher ovarian volume. Thyroid nodule was a significant predictor for higher ovarian volume. Conclusion Our study is the first to analyze the association between IGF-1 and thyroid nodule in PCOS. We found that thyroid nodule was associated with thyroid and ovarian volume, but IGF-1 was not associated with thyroid nodule, thyroid or ovarian volume.
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Affiliation(s)
- O Topaloglu
- Kocaeli Derince Training and Research Hospital - Endocrinology, Kocaeli, Inonu University School of Medicine
| | | | - M Uzun
- University of Health Sciences, Izmir Suat Seren Chest Diseases and Surgery Training and Research Hospital - Intensive Care Unit, Izmir, Turkey
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Le NSV, Le MT, Nguyen ND, Tran NQT, Nguyen QHV, Cao TN. A Cross-Sectional Study on Potential Ovarian Volume and Related Factors in Women with Polycystic Ovary Syndrome from Infertile Couples. Int J Womens Health 2021; 13:793-801. [PMID: 34512036 PMCID: PMC8412837 DOI: 10.2147/ijwh.s329082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/15/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study was designed to explore the value of ovarian volume (OV) measured by transvaginal ultrasound and its relationship with anthropometry and serum hormonal levels in a polycystic ovary syndrome (PCOS) population. Patients and Methods A total of 119 women with PCOS from infertile couples were recruited in this cross-sectional study. On days 2-4 of the menstrual cycle, transvaginal ultrasound examinations were performed, and hormonal profiles were measured. PCOS diagnosis was based on the Rotterdam 2003 criteria and classified into four phenotype groups. The PCOS group (study group) and the non-PCOS group (control group) were compared. Results The mean age of the participants was 32.66±4.10 years compared to 33.99±4.78 years in 273 cases (69.6%) without PCOS. The mean OV was statistically larger in the PCOS group than in the non-PCOS group (7.65±3.23 mL vs 6.08±3.67 mL, p < 0.001) and positively correlated with serum anti-Mullerian (AMH) and luteinizing hormone (LH) levels (r=0.30; p < 0.001 and r=0.23; p < 0.001, respectively), and weakly and inversely correlated with age (-0.182, p < 0.001). The area under the receiver operating characteristic (ROC) curve of OV in the diagnosis of PCOS was 0.613 (0.557-0.670, 95% CI). Conclusion The enlarged OV is remarkable in women with PCOS and is related to AMH and LH concentrations. Although the diagnostic potential of PCOS is substantially low, OV alone may contribute to predicting the severity of PCOS and better performance for the diagnosis of PCOS phenotypes.
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Affiliation(s)
- Nguyen Sa Viet Le
- Department of Assisted Reproduction, Hue Central Hospital, Hue, Vietnam.,Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Minh Tam Le
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Nguyen Dac Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Nhu Quynh Thi Tran
- Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Quoc Huy Vu Nguyen
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thanh Ngoc Cao
- Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
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Suardi D, Permadi W, Djuwantono T, Hidayat YM, Bayuaji H, Edo Gautama GP. Correlation of Serum Anti-Mullerian Hormone (AMH) Level on Ovarian Volume in Women with Endometrioma. Int J Gen Med 2021; 14:1-8. [PMID: 33442285 PMCID: PMC7797296 DOI: 10.2147/ijgm.s272071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/19/2020] [Indexed: 01/09/2023] Open
Abstract
Background The correlation between endometrioma and serum Anti-mullerian hormone (AMH) level is a benchmark in determining the prognosis and management of endometrioma. Endometrioma causes a decrease in ovarian reserve due to tissue damage that affects the formation of serum AMH. Serum AMH levels in daily practice are useful as a tool to determine ovarian reserve, markers for diagnosis and prognosis in infertility and reproductive abnormalities. The purpose of this study was to determine the relationship of serum AMH level in women with endometrioma and their correlation to ovarian volume. Methods This research was an analytical observational study with a cross-sectional design in women of reproductive age who were diagnosed with endometrioma within the period of August 2019–March 2020 at Hasan Sadikin Hospital, Bandung. Forty-four women who met the inclusion and exclusion criteria were then divided into endometrioma (n=22) and control (n=22) groups. In both groups, transvaginal ultrasound examination was performed to measure the volume of the ovary, then a laboratory examination of serum AMH level was carried out. Results Serum AMH levels in the endometrioma group were significantly lower than those in the control group (P<0.001). Serum AMH level did not differ significantly based on laterality of the observation group (P=1.000). There was a negative correlation between serum AMH level and the volume of ovarian endometrioma, although not statistically significant (r=−0.332; P=0.066). Conclusion There was a correlation between serum AMH level and endometrioma. Serum AMH levels were significantly lower in the endometrioma group but were not influenced by their laterality. We found a negative correlation between serum AMH level and ovarian volume containing endometrioma, but not statistically significant.
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Affiliation(s)
- Dodi Suardi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Wiryawan Permadi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Tono Djuwantono
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Yudi Mulyana Hidayat
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Hartanto Bayuaji
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Gusti Putu Edo Gautama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
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Turgut GD, Mulayim B, Karadag C, Karadag B, Tatar SA, Yuksel BA. Comparison of the effects of bilateral and unilateral laparoscopic ovarian drilling on pregnancy rates in infertile patients with polycystic ovary syndrome. J Obstet Gynaecol Res 2020; 47:778-784. [PMID: 33331128 DOI: 10.1111/jog.14610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 11/09/2020] [Accepted: 12/05/2020] [Indexed: 11/27/2022]
Abstract
AIM This study aims to investigate the effects of unilateral and bilateral laparoscopic ovarian drilling (LOD) on pregnancy rates in patients with clomiphene citrate (CC) resistant infertile polycystic ovary syndrome. METHODS This prospective cohort study included 75 patients who were admitted to the Department of Obstetrics and Gynecology of the Antalya Training and Research Hospital between July 2016 and December 2017 and underwent LOD operation. Among these patients, 37 underwent unilateral laparoscopic ovarian drilling (ULOD) and 38 underwent bilateral laparoscopic ovarian drilling (BLOD). The drilling procedure was carried out using the following equation: Number of punctures (np) = 60 J/cm3 /30 watt × 4 s by selecting the larger ovary in the patients who underwent ULOD and by taking the ovarian volume of each ovary in the BLOD group. RESULTS During the 1-year follow-up, 20 of the ULOD patients (54.1%) and 13 of the BLOD patients (34.2%) were observed to be pregnant. Although a higher number of pregnancies were obtained in the ULOD group, no statistically significant difference was found between the two groups (P = 0.083). The pregnancies occurred more in the first 6 months during the postoperative follow-ups of the patients. A total of 14 (70%) of the 20 pregnancies in the ULOD group and 9 (69.2%) of the 13 pregnancies in the BLOD group occurred in the first 6 months. CONCLUSION ULOD with respect to a larger ovarian volume should be preferred to BLOD for CC-resistant PCOS patients because of the high pregnancy rates and fewer potential side effects.
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Affiliation(s)
- Gokce D Turgut
- Department of Obstetrics and Gynecology, Saglık Bilimleri University Antalya Training and Research Hospital, Antalya, Turkey
| | - Baris Mulayim
- Department of Obstetrics and Gynecology, Saglık Bilimleri University Antalya Training and Research Hospital, Antalya, Turkey
| | - Ceyda Karadag
- Department of Obstetrics and Gynecology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Burak Karadag
- Department of Obstetrics and Gynecology, Saglık Bilimleri University Antalya Training and Research Hospital, Antalya, Turkey
| | - Sezin A Tatar
- Department of Obstetrics and Gynecology, Saglık Bilimleri University Antalya Training and Research Hospital, Antalya, Turkey
| | - Burcu A Yuksel
- Department of Obstetrics and Gynecology, Saglık Bilimleri University Antalya Training and Research Hospital, Antalya, Turkey
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Khashchenko E, Uvarova E, Vysokikh M, Ivanets T, Krechetova L, Tarasova N, Sukhanova I, Mamedova F, Borovikov P, Balashov I, Sukhikh G. The Relevant Hormonal Levels and Diagnostic Features of Polycystic Ovary Syndrome in Adolescents. J Clin Med 2020; 9:E1831. [PMID: 32545404 DOI: 10.3390/jcm9061831] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/08/2020] [Accepted: 06/10/2020] [Indexed: 11/20/2022] Open
Abstract
Relevance: The clinical picture of polycystic ovary syndrome (PCOS) is extremely polymorphic, especially in adolescence. At the same time, the diagnostic criteria of PCOS in adolescence are still under discussion, and the hormonal parameters, including anti-Mullerian hormone range and hyperandrogenism, are not determined. The aim of the present study was to characterize the pivotal clinical and hormonal features of PCOS in adolescents and to establish the age-specific thresholds of the most essential hormonal parameters. Design: A case-control study. Methods: The study included 130 girls with PCOS according to the complete Rotterdam criteria, aged 15 to 17 years. The control group consisted of 30 healthy girls with a regular menstrual cycle of the same age. A complete clinical and laboratory examination, hormonal assays, and ultrasound of the pelvic organs were performed. The serums anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, prolactin, estradiol, 17α-OH progesterone (17α-OHP), androstenedione, testosterone (T), dehydroepiandrosterone sulfate (DHEAS), sex hormone-binding globulin (SHBG), leptin, and free androgen index (FAI) were analyzed. The diagnostic accuracy of AMH, FAI, LH/FSH, T, and androstenedione levels in predicting PCOS in adolescents was established using a logistic regression model and calculating area under the receiver operator characteristic (ROC) curve (AUC). Results: The serum levels of LH (9.0 (5.4–13.8) vs. 3.7 (2.5–4.7) IU/L; p < 0.0001), LH/FSH (1.6 (1.0–2.3) vs. 0.7 (0.5–1.1); p < 0.0001), 17α–OHP (4.1 (3.2–5.1) vs. 3.4 (2.7–3.8) nmol/L; p = 0.0071), cortisol (464.0 ± 147.6 vs. 284.0 ± 129.7 nmol/L; p < 0.0001), prolactin (266.0 (175.0–405.0) vs. 189.0 (142.0–269.0) mIU/L; p = 0.0141), T (1.9 (1.2–2.5) vs. 0.8 (0.7–1.1) nmol/L; p < 0.0001), androstenedione (15.8 (11.6–23.2) vs. 8.3 (6.5–10.8) ng/mL; p < 0.0001), AMH (9.5 (7.5–14.9) vs. 5.8 (3.8–6.9) ng/mL; p < 0.0001), FAI (5.5 (2.8–7.0) vs. 1.6 (1.1–2.3); p < 0.0001), SHBG (37.0 (24.7–55.5) vs. 52.9 (39.0–67.6) nmol/L; p = 0.0136), DHEAS (6.8 ± 3.2 vs. 5.1 ± 1.5 μmol/L; p = 0.0039), and leptin (38.7 ± 27.1 vs. 23.7 ± 14.0 ng/mL; p = 0.0178) were significantly altered in the PCOS patients compared to the controls. Multivariate analysis of all studied hormonal and instrumental parameters of PCOS in adolescents revealed as the most essential: AMH level > 7.20 ng/mL, FAI > 2.75, androstenedione > 11.45 ng/mL, total T > 1.15 nmol/L, LH/FSH ratio > 1.23, and the volume of each ovary > 10.70 cm3 (for each criterion sensitivity ≥ 75.0–93.0%, specificity ≥ 83.0–93.0%). The diagnostic accuracy of PCOS determination was 90.2–91.6% with the combined use of either four detected indexes, which was significantly higher than the use of each index separately. The accuracy of PCOS diagnostics reached 92% using AMH and leptin concentrations when the value of the logistic regression function [85.73 − (1.73 × AMH) − (0.12 × Leptin)] was less than 70.72. Conclusions: The results of the study estimate the threshold for AMH, FAI, androstenedione, testosterone, LH/FSH, and ovarian volume, which could be suggested for use in the PCOS diagnostics in adolescents with a high sensitivity and specificity. Moreover, the combination of either four determined indexes improved the diagnostic accuracy for the PCOS detection in adolescents.
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12
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Abstract
The aim of this study was to investigate the relationship between serum estrone (E1) level and other cardinal features in women with polycystic ovary syndrome (PCOS). 133 Korean women aged 18-35 years who were newly diagnosed with PCOS at a university hospital were included in the present study. Blood samples were collected from all participants during the early follicular phase to determine the serum E1 level and other biochemical hormonal parameters. The total antral follicle count (TFC) and the total ovarian volume (TOV) were assessed using transvaginal or transrectal ultrasound. A significant correlation was found between serum E1 and luteinizing hormone (LH) levels in women with PCOS. In addition, statistically significant correlations were observed between serum E1 level and other hormonal parameters, including testosterone, free testosterone, dehydroepiandrosterone sulfate, and 17α-hydroxyprogesterone. With respect to the ultrasound features, serum E1 levels were significantly correlated with TFC and TOV. All results did not change after adjusting for body mass index (BMI). In conclusion, serum E1 level is significantly correlated with serum LH and androgen levels, and it may be a useful marker for representing the status of the ovarian volume in women with PCOS.
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Affiliation(s)
- Sungwook Chun
- Department of Obstetrics & Gynecology, Inje University Haeundae Paik Hospital, Busan, Korea
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13
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Armeni E, Tsitoura A, Aravantinos L, Vakas P, Augoulea A, Rizos D, Antoniou A, Alexandrou A, Deligeoroglou E, Lambrinoudaki I. Ovarian volume is associated with adiposity measures and bone mineral density in postmenopausal women. J Musculoskelet Neuronal Interact 2018; 18:501-508. [PMID: 30511954 PMCID: PMC6313034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The present study aimed to assess the association between ovarian volume and demographic and anthropometric parameters, as well as sex hormones and bone mineral density (BMD) in postmenopausal women. METHODS 161 healthy postmenopausal women participated in this cross-sectional study. Fasting venous blood samples were obtained for biochemical/hormonal assessment. Anthropometric parameters included body mass index (BMI) and waist-to-hip ratio (WHR). Ultrasonography was used to estimate the average ovarian volume for each participant. BMD was measured in the femoral neck (FN) and the lumbar spine (LS) using DXA. RESULTS Mean ovarian volume increased linearly with increasing quartiles of BMI (Q1:0.985±0.25, Q2: 1.11±0.29, Q3: 1.07±0.28, Q4: 1.19±0.38, p-value for linear trend 0.013). Ovarian volume correlated positively with BMI (r=0.128, p-value=0.038), FN BMD (r=0.233, p-value=0.003), FN T-score (r=0.223, p-value=0.004) and FN Z-score (r=0.171, p-value=0.027). Multivariate analysis showed that ovarian volume was predicted by WHR (b-coefficient=0.157, p-value=0.047) and SHBG (b-coefficient= -0.160, p-value=0.042), independently of age and BMI. Finally, FN BMD was predicted by ovarian volume, independently of age, menopausal age and BMI. CONCLUSION Ovarian volume was positively and independently associated with adiposity indexes and femoral BMD in postmenopausal women. Lower SHBG levels were associated with higher ovarian volume. Insulin resistance may mediate these results. The significance of these findings should be assessed in larger prospective studies.
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Affiliation(s)
- Eleni Armeni
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Tsitoura
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Leon Aravantinos
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Vakas
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Areti Augoulea
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Demetrios Rizos
- Hormonal Laboratory, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Aris Antoniou
- Department of Radiology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Alexandrou
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Efthymios Deligeoroglou
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Athens, Greece,Corresponding author: Associate Professor Irene Lambrinoudaki, 27 Themistokleous street, Dionysos, GR-14578, Athens, Greece E-mail:
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14
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Abstract
AIM To evaluate the ovarian reserve function in female patients with obesity in comparison with women without obesity. MATERIALS AND METHODS This study evaluated 500 caucasian women, age 20-30 years, 250 with obesity (body mass index, BMI ≥30 kg/m2) and 250 without obesity (BMI <30 kg/m2). Anthropometrics, serum concentrations of anti-Mullerian hormone (AMH), inhibin B, follicle stimulating hormone, luteinizing hormone, estradiol, progesterone, and testosterone were compared as ovarian volume (cm3) and antral follicle count (AFC), determined by ovarian transvaginal ultrasonography. RESULTS We reveal statistically significant difference in following parameters: AMH (2.7±0.47 ng/ml vs. 3.8±0.63 ng/ml; p<0.05), testosterone (1.4±0.3 nmol/l vs. 0.7±0.2 nmol/l; p<0.01), ovarian volume (7.2±1.9 cm3 vs 9.5±1.7 cm3; p<0.05), and AFC (13.3±4.5 vs 20.7±7.2; p<0.01) in obesity group vs. control group respectively. CONCLUSION Ovarian reserve function is significantly lower in obese patients than in healthy control subjects of young reproductive age, but ovarian reserve parameters are in normal reference range even in obese patients.
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Affiliation(s)
- O R Grigoryan
- Scientific Center for Endocrinology, Ministry of Health of Russia, Moscow, Russia
| | - R K Mikheev
- Scientific Center for Endocrinology, Ministry of Health of Russia, Moscow, Russia.,A.I. Evdokimov Moscow State University of Medicine and Dentistry Ministry of Health of Russia, Moscow, Russia
| | - E N Andreeva
- Scientific Center for Endocrinology, Ministry of Health of Russia, Moscow, Russia.,A.I. Evdokimov Moscow State University of Medicine and Dentistry Ministry of Health of Russia, Moscow, Russia
| | - I I Dedov
- Scientific Center for Endocrinology, Ministry of Health of Russia, Moscow, Russia
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15
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Mathyk BA, Cetin BA, Atakul N, Koroglu N, Bahat PY, Turan G, Yuksel IT. Ovarian reserve after internal iliac artery ligation. J Obstet Gynaecol Res 2018; 44:1761-1765. [PMID: 29974589 DOI: 10.1111/jog.13719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/01/2018] [Indexed: 11/30/2022]
Abstract
AIM Ligation of major vessels supplying ovaries may alter hormones and ovarian reserve due to disturbances of vascular circulation. Our purpose is to measure serum anti-Müllerian hormone (AMH) levels and ovarian volume in patients who had internal iliac artery ligation (IIAL) and/or IIAL plus hysterectomy due to uterine atony. METHODS Patients who underwent IIAL and IIAL+ hysterectomy were evaluated 6 months after their operations and were compared with the control group. The hormones, ovarian volume and antral follicle count (AFC) were measured in each group. RESULTS Serum AMH levels in the post-partum 6th month interval were lower in the IIAL group than in the control group and were the lowest in the IIAL+ hysterectomy group. Similar to AMH results, AFC and ovarian volumes were also lowest in the IIAL+ hysterectomy group. CONCLUSION IIAL and hysterectomy are lifesaving interventions during peripartum hemorrhage; however, they might alter ovarian reserve in the short term.
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Affiliation(s)
- Begum A Mathyk
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Berna A Cetin
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Nil Atakul
- Department of Obstetrics and Gynecology, Istanbul Training and Research Hospital, Istanbul, Turkey
| | - Nadiye Koroglu
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Pinar Y Bahat
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Gokce Turan
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Ilkbal T Yuksel
- Department of Obstetrics and Gynecology, Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
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16
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Abstract
Polycystic ovarian syndrome (PCOS) is a common endocrinopathy. The Rotterdam criteria indicate four distinct phenotypes. In phenotypes with the typical ovarian morphology (ovarian volume ≥10 ml) the sensibility to clomiphene citrate (CC) ovulation therapy was demonstrated inversely proportional to the ovarian volume. In this retrospective study we evaluated the influence of ovarian volume on the success rate of CC ovulation induction in women with anovulatory phenotype 2 characterized only by the presence of hyperandrogenism and anovulation (ANOV + HA). Statistical analysis was conducted by stratifying patients both on the basis of CC dose (Group 1: n = 37, 50 mg; Group 2: n = 9, 100 mg; and Group 3: n = 12, 150 mg) and on the basis of response to therapy. Eighty women were evaluated but overall only 58 women (72.5%) reached ovulation. In the phenotype studied, we didn't find any correlations between ovarian volume and the chance of ovulation with the gradient increase in CC; furthermore, ovarian volume was comparable in CC responders and non-responders. Our study has shown that in the phenotype 2 examined, ovarian volume did not have any predictive value of the dosage required to induce ovulation. The significance of this result is discussed.
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Affiliation(s)
| | - Luigi Della Corte
- b Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II , Naples , Italy
| | - Nicoletta De Rosa
- b Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II , Naples , Italy
| | - Antonio Mercorio
- b Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II , Naples , Italy
| | - Dario Bruzzese
- a Department of Public Health , University of Naples Federico II , Naples , Italy
| | - Giuseppe Bifulco
- b Department of Neuroscience, Reproductive Sciences and Dentistry , University of Naples Federico II , Naples , Italy
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17
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Giampaolino P, Morra I, De Rosa N, Cagnacci A, Pellicano M, Di Carlo C, Nappi C, Bifulco G. Impact of transvaginal hydrolaparoscopy ovarian drilling on ovarian stromal blood flow and ovarian volume in clomiphene citrate-resistant PCOS patients: a case-control study. Gynecol Endocrinol 2017; 33:690-693. [PMID: 28412862 DOI: 10.1080/09513590.2017.1310837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in gynecology. In PCOS patients vascularization parameters are altered. Transvaginal hydrolaparoscopy (THL) is a mini-invasive approach for ovarian drilling in PCOS patients. In this study, we assessed the effect of ovarian drilling using THL on ovarian volume (OV) and vascularization index (VI) using 3D power Doppler ultrasonography in CC-resistant PCOS patients. A case-control study on 123 CC-resistant PCOS women who underwent THL ovarian drilling was performed. Patients underwent 3D ultrasound and power Doppler to measure VI, flow index (FI), vascularization flow index (VFI) and to evaluate OV before and after the procedure, at six months, and on the early follicular phase of the menstrual cycle. After THL ovarian drilling, OV and power Doppler flow indices were significantly reduced compared to pre-operative values (OV: 7.85 versus 11.72 cm3, p < 0.01; VI: 2.50 versus 4.81, p < 0.01; VFI: 1.10 versus 2.16, p < 0.01; FI: 32.05 versus 35.37, p < 0.01). In conclusion, THL ovarian drilling seems to reduce OV and 3D power Doppler indices, and could therefore be a viable alternative to LOD in PCOS patients resistant to medical therapy.
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Affiliation(s)
| | - Ilaria Morra
- b Department of Obstetrics, Gynecology, and Urology , University of Naples "Federico II" , Naples , Italy , and
| | - Nicoletta De Rosa
- b Department of Obstetrics, Gynecology, and Urology , University of Naples "Federico II" , Naples , Italy , and
| | - Angelo Cagnacci
- c Department of Obstetrics and Gynecology , University of Udine , Udine , Italy
| | - Massimiliano Pellicano
- b Department of Obstetrics, Gynecology, and Urology , University of Naples "Federico II" , Naples , Italy , and
| | - Costantino Di Carlo
- b Department of Obstetrics, Gynecology, and Urology , University of Naples "Federico II" , Naples , Italy , and
| | - Carmine Nappi
- a Department of Public Health , University of Naples "Federico II" , Naples , Italy
| | - Giuseppe Bifulco
- b Department of Obstetrics, Gynecology, and Urology , University of Naples "Federico II" , Naples , Italy , and
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18
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Korsholm AS, Hvidman HW, Bentzen JG, Nyboe Andersen A, Birch Petersen K. Left-right differences in ovarian volume and antral follicle count in 1423 women of reproductive age. Gynecol Endocrinol 2017; 33:320-323. [PMID: 27910705 DOI: 10.1080/09513590.2016.1259406] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The aim of this cross-sectional study was to investigate side differences in antral follicle count (AFC) and ovarian volume in left versus right ovaries in relation to chronological and "biological" age, the latter estimated by anti-Müllerian hormone (AMH) levels. The cohort comprised 1423 women: 1014 fertile and 409 infertile. All were examined by transvaginal sonography and serum AMH. Overall the right ovary contained 8.1% more antral follicles (p = 0.002) and had 10.7% larger volume compared with the left (p < 0.001). In all AMH quartiles, the right ovarian volume was larger than the left (p ≤ 0.003). AFC was significantly higher in the right compared to the left ovary in the three upper AMH quartiles (p ≤ 0.005). The findings were similar when stratified in age quartiles. More than half (54.8%) had polycystic ovarian (PCO) morphology in at least one ovary. Of these women, 46.3% (n = 361) had PCO morphology unilateral - most frequently on the right side (27.6%) compared to the left (18.7%, p < 0.001). The consistent difference in AFC and ovarian volume found in AMH and age quartiles may be explained by presence of a larger pool of primordial follicles in the right ovary established during fetal life.
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Affiliation(s)
- Anne-Sofie Korsholm
- a The Fertility Clinic, Copenhagen University Hospital , Copenhagen , Denmark
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19
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El Issaoui M, Giorgione V, Mamsen LS, Rechnitzer C, Birkebæk N, Clausen N, Kelsey TW, Andersen CY. Effect of first line cancer treatment on the ovarian reserve and follicular density in girls under the age of 18 years. Fertil Steril 2016; 106:1757-1762.e1. [PMID: 27717554 DOI: 10.1016/j.fertnstert.2016.09.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/24/2016] [Accepted: 09/02/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To study the impact of first-line antineoplastic treatment on ovarian reserve in young girls returning for ovarian tissue cryopreservation (OTC) in connection with a relapse. DESIGN Retrospective case-control study. SETTING University hospitals. PATIENT(S) Sixty-three girls under the age of 18 years who underwent OTC before (group 1: 31 patients) and after (group 2: 32 patients) their initial cancer treatment. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Follicular densities (follicles/mm3) measured from an ovarian cortical biopsy before OTC. The ovarian volume (mL) of entire ovaries excised for OTC was also monitored. RESULT(S) There was no statistically significant difference in the mean age or follicular density between groups 1 and 2 (334 ± 476/mm3 vs. 327 ± 756/mm3). In contrast, the ovarian volume and total number of ovarian cortex chips cryopreserved were statistically significantly lower in patients who received gonadotoxic treatment before OTC (mean ± standard deviation [SD]: ovarian volume, 5.3 ± 3.1 mL vs. 2.9 ± 2.1 mL, respectively; number of cortex chips: 21.3 ± 8.1 vs. 15.2 ± 7.1, respectively). The reduction in the estimated ovarian reserve ranged from 10% to 20% in children to around 30% in adolescent girls (>10 years). CONCLUSION(S) Girls under the age of 10 tolerate a gonadotoxic insult better than adolescents, who may experience up to a 30% reduction in the ovarian reserve via first-line gonadotoxic treatment, which at present is considered to have little effect on the follicle pool. This information will improve counseling of young female cancer patients in deciding whether to undergo fertility preservation treatment.
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Affiliation(s)
- Meryam El Issaoui
- Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Veronica Giorgione
- Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Linn S Mamsen
- Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Catherine Rechnitzer
- Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Copenhagen University Hospital, Copenhagen, Denmark
| | - Niels Birkebæk
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Niels Clausen
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas W Kelsey
- School of Computer Science, University of St. Andrews, St. Andrews, United Kingdom
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Karakus S, Yildiz C, Aydin H, Akkar O, Cetin A. Value of in situ ovarian volume measured during cesarean delivery to assess the potential of diminished ovarian reserve. J Matern Fetal Neonatal Med 2016; 30:1016-1022. [PMID: 27278442 DOI: 10.1080/14767058.2016.1199670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We aimed to determine the value of mean ovarian volume (OV) determined by three-dimensional in situ measurement of ovaries during cesarean delivery (CD) to assess the potential of diminished ovarian reserve (DOR) evaluated by hormonal and ultrasonographic parameters 3 months after the cesarean delivery. METHODS Each ovary was measured underwent CD in three dimensions, and three months after CD, the mean OV, serum AMH, FSH, LH, and estradiol levels, and antral follicle count (AFC) values were recorded as well as other demographic and obstetric parameters. RESULTS After categorizing the study subjects as having a potential of DOR by the criteria of serum AMH <1 pg/mL and AFC value ≤6, in patients with a potential of DOR, the mean intra-operative and post-operative OVs were significantly decreased (p < 0.05). Considering the correlation coefficients obtained by the correlations of post-operative AMH level and AFC value with the mean intra-operative and post-operative OV values, the mean intra-operative OV provided significantly higher correlation coefficients (p < 0.05). CONCLUSIONS These findings, overall, support the diagnostic value of mean OV determined by the in situ measurement of three dimensions of left and right ovaries during cesarean delivery for the screening of potential for the DOR.
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Affiliation(s)
| | | | - Huseyin Aydin
- b Department of Biochemistry , Cumhuriyet University School of Medicine , Sivas , Turkey
| | - Ozlem Akkar
- a Department of Obstetrics and Gynecology and
| | - Ali Cetin
- a Department of Obstetrics and Gynecology and
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21
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Cagnacci A, Bellafronte M, Xholli A, Palma F, Carbone MM, Di Carlo C, Grandi G. Impact of laparoscopic cystectomy of endometriotic and non-endometriotic cysts on ovarian volume, antral follicle count (AFC) and ovarian doppler velocimetry. Gynecol Endocrinol 2016; 32:298-301. [PMID: 26850447 DOI: 10.3109/09513590.2016.1142523] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the effect on ovarian reserve and blood flow of unilateral laparoscopic stripping of endometriotic versus non-endometriotic cysts. DESIGN Prospective observational study. SETTING Tertiary university gynecology unit. PATIENTS During the study period, 71 subjects underwent the first laparoscopic surgery for removal of a monolateral benign ovarian cyst. INTERVENTIONS Trans-vaginal ultrasound scans of the pelvis about six months after surgery. MAIN OUTCOME MEASURES Ovarian volume, Antral Follicle Count (AFC) and Resistance Index (RI) of ovarian artery of the operated and the contralateral ovary. RESULTS Among 71 cysts, 39.4% were endometriotic and 60.6% non-endometriotic benign cysts. All the procedures were performed by the same experienced surgeons with a standardized technique. No major complications were reported during surgery. The mean (±SD) age and BMI of women were 31.0 ± 6.8 years and 24.2 ± 3.3 kg/m(2), respectively. Mean diameter of the removed cysts was smaller for endometriotic than non-endometriotic cysts (4.35 ± 1.77 cm versus 6.33 ± 3.71 cm, p = 0.046). In comparison to non-operated, volume of the operated ovary was significantly lower and with a reduced AFC, with no difference between endometriotic and non-endometriotic cysts (-2.41 ± 2.35 versus -2.00 ± 2.23 cm(3), p = 0.496) (-3.45 ± 3.07 versus -2.43 ± 1.95, p = 0.11). Ovarian artery RI was higher in the operated ovary with no difference between endometriotic and non-endometriotic cysts (0.19 ± 0.14 versus 0.14 ± 0.10, p = 0.455). The difference in ovarian volume (r = 0.178), AFC (r = 0.094) and RI (r = 0.079) between operated and non-operated ovary was not dependent on the diameter of the removed cyst. CONCLUSION Ovarian surgery is associated with a decline of ovarian reserve, independently on the histological type and the diameter of the removed cyst.
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Affiliation(s)
- Angelo Cagnacci
- a Department of Obstetrics , Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero Universitaria Policlinico of Modena , Modena , Italy and
| | - Manuela Bellafronte
- a Department of Obstetrics , Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero Universitaria Policlinico of Modena , Modena , Italy and
| | - Anjeza Xholli
- a Department of Obstetrics , Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero Universitaria Policlinico of Modena , Modena , Italy and
| | - Federica Palma
- a Department of Obstetrics , Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero Universitaria Policlinico of Modena , Modena , Italy and
| | - Maria Maddalena Carbone
- a Department of Obstetrics , Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero Universitaria Policlinico of Modena , Modena , Italy and
| | - Costantino Di Carlo
- b Department of Obstetrics and Gynecology , University Federico II , Naples , Italy
| | - Giovanni Grandi
- a Department of Obstetrics , Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero Universitaria Policlinico of Modena , Modena , Italy and
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22
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Sepúlveda M, Ros C, Martínez-Lapiscina EH, Solà-Valls N, Hervàs M, Llufriu S, La Puma D, Casals E, Blanco Y, Villoslada P, Graus F, Castelo-Branco C, Saiz A. Pituitary-ovary axis and ovarian reserve in fertile women with multiple sclerosis: A pilot study. Mult Scler 2015; 22:564-8. [PMID: 26362892 DOI: 10.1177/1352458515602339] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 07/26/2015] [Indexed: 11/17/2022]
Abstract
Since a decline in the ovary function might impact the reproductive potential in women with multiple sclerosis (MS), we investigated the pituitary-ovary axis and ovarian reserve, including anti-Müllerian hormone (AMH) levels and ultrasound imaging of the ovaries, of 25 relapsing-remitting MS patients and 25 age-matched healthy controls. Mean levels of pituitary-gonadal hormones and age-adjusted parameters of ovarian reserve markers were not significantly different between both groups. Patients with higher disease activity (annualized relapse rate >0.5; n=9) had significantly lower AMH levels, total antral follicle count and ovarian volume, than those with lower disease activity. The finding of poorer ovarian reserve associated with higher disease activity should be taken into consideration since it may negatively impact the reproductive prognosis.
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Affiliation(s)
- Maria Sepúlveda
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Cristina Ros
- Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic and IDIBAPS, Universitat de Barcelona, Spain
| | - Elena H Martínez-Lapiscina
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Nuria Solà-Valls
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Mariona Hervàs
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic of Barcelona and Hospital Parc Tauli,Spain
| | - Sara Llufriu
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Delon La Puma
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Elena Casals
- Biomedical Diagnostic Center, Hospital Clinic of Barcelona, Spain
| | - Yolanda Blanco
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Pablo Villoslada
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Francesc Graus
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
| | - Camil Castelo-Branco
- Institut Clinic of Gynecology, Obstetrics and Neonatology, Hospital Clinic and IDIBAPS, Universitat de Barcelona, Spain
| | - Albert Saiz
- Center for Neuroimmunology, Service of Neurology, Hospital Clinic and Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Spain
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Saxena R, Bjonnes AC, Georgopoulos NA, Koika V, Panidis D, Welt CK. Gene variants associated with age at menopause are also associated with polycystic ovary syndrome, gonadotrophins and ovarian volume. Hum Reprod 2015; 30:1697-703. [PMID: 25994816 DOI: 10.1093/humrep/dev110] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 04/24/2015] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Is there a relationship between the genetic risk for polycystic ovary syndrome (PCOS) and genetic variants that influence timing of menopause? SUMMARY ANSWER The genetic risk score, which sums the contribution of variants at all menopause loci, was associated with PCOS. WHAT IS ALREADY KNOWN Ovarian parameters and anti-Mullerian hormone levels suggest that women with PCOS should have a later age at menopause. STUDY DESIGN, SIZE, DURATION The study was a case-control examination of genetic variants associated with age at menopause in a discovery cohort of women with PCOS (n = 485) and controls (n = 407) from Boston recruited from 2003 to 2012. Replication was performed in women from Greece (cases, n = 884 and controls, n = 311). PARTICIPANTS/MATERIALS, SETTINGS, METHODS PCOS was defined by the National Institutes of Health criteria in Boston and Greece (n = 783), with additional subjects fulfilling the Rotterdam criteria (hyperandrogenism, polycystic ovary morphology and regular menses) in Greece (n = 101). Controls in Boston and Greece had regular menstrual cycles and no hyperandrogenism. Allele frequencies for variants previously associated with age at menopause were examined in PCOS cases and controls, along with the relationship to quantitative traits. MAIN RESULTS AND ROLE OF CHANCE The variant rs11668344-G was associated with decreased risk of PCOS (odds ratio: 0.77 [0.59-0.93]; P = 0.004). There was a strong relationship between the late menopause allele rs12294104-T and increased LH levels (β ± SE; 0.26 ± 0.06; P = 5.2 × 10(-5)) and the LH:FSH ratio (0.28 ± 0.06; P = 2.7 × 10(-6)). The minor allele at rs10852344-T was associated with smaller ovarian volume (-0.16 ± 0.05; P = 0.0012). A genetic risk score calculated from 16 independent variants associated with age at menopause was also associated with PCOS (P < 0.02), LH and the LH:FSH ratio (both P < 0.05). LIMITATIONS, REASONS FOR CAUTION The variant rs11668344 was not associated with PCOS in the Greek cohort, but results exhibited the same direction of effect as the Boston cohort. However, it is possible that the individual association was a false positive in the Boston cohort. WIDER IMPLICATIONS OF THE FINDINGS The study demonstrates that gene variants known to influence age at menopause are also associated with risk for PCOS. Further, our data suggest that the relationship between age at menopause and PCOS may be explained, at least in part, by effects on LH levels and follicle number. The data point to opposing influences of the genetic variants on both menopausal age and PCOS. STUDY FUNDING/COMPETING INTERESTS The project was supported by award number R01HD065029 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development, award number 1 UL1 RR025758, Harvard Clinical and Translational Science Center, from the National Center for Research Resources and award 1-10-CT-57 from the American Diabetes Association. C.K.W. is a consultant for Takeda Pharmaceuticals. TRIAL REGISTRATION NUMBER NCT00166569.
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Affiliation(s)
- R Saxena
- Department of Anaesthesia and Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
| | - A C Bjonnes
- Department of Anaesthesia and Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA 02114, USA
| | - N A Georgopoulos
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, Patras 26500, Greece
| | - V Koika
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, Patras 26500, Greece
| | - D Panidis
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School, Patras 26500, Greece Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki 54621, Greece
| | - C K Welt
- Division of Endocrinology, Metabolism and Diabetes, University of Utah, EIHG, 15 N 2030 E, Salt Lake City, UT 84112, USA
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Ozdemir O, Sari ME, Kalkan D, Koc EM, Ozdemir S, Atalay CR. Comprasion of ovarian stromal blood flow measured by color Doppler ultrasonography in polycystic ovary syndrome patients and healthy women with ultrasonographic evidence of polycystic. Gynecol Endocrinol 2015; 31:322-6. [PMID: 25558942 DOI: 10.3109/09513590.2014.995617] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To compare ovarian stromal artery blood flows measured by Doppler ultrasonography of polycystic ovary syndrome (PCOS) patients and healthy women with polycystic ovarian image in ultrasonography. METHODS Forty-two patients diagnosed with PCOS according to the criteria of 2003 Rotterdam Concencus Conferance on PCOS and 38 healthy volunteers with polycystic ovarian image in ultrasonography were included in the study. Ovarian volumes and ovarian stromal artery blood flows were measured by 3-dimensional (3-D) ultrasonography and Doppler ultrasonography in all patients. RESULTS In patients with PCOS, ovarian stromal artery pulsatility index (PI) and resistivity index (RI) were found significantly different from healthy women with polycystic ovarian image in ultrasonography (p < 0.05). 3-D ovarian volumes were found significantly higher in patients with PCOS (p < 0.05), and a negative correlation was also obtained between ovarian volumes and ovarian stromal artery resistivity indices. CONCLUSION Ovarian stromal artery Doppler examination could have an importance to explain the pathophysiology of PCOS, but there are few publications in the literature about PCOS and the details of ovarian stromal artery Doppler parameters in patients with polycystic ovarian image only. We conclude that Doppler ultrasonography findings of PCOS patients might be helpful in understanding the clinical follow-up and etiology of the disease.
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Affiliation(s)
- Ozhan Ozdemir
- Department of Obstetrics and Gynecology, Ankara Numune Education and Research Hospital , Ankara , Turkey
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25
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Bhat RG, Dhulked S, Ramachandran A, Bhaktha R, Vasudeva A, Kumar P, Rao ACK. Laparoscopic cystectomy of endometrioma: Good surgical technique does not adversely affect ovarian reserve. J Hum Reprod Sci 2014; 7:125-9. [PMID: 25191026 PMCID: PMC4150139 DOI: 10.4103/0974-1208.138871] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/14/2014] [Accepted: 06/16/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: The damage to ovarian reserve inflicted by surgery for endometriosis represents a major concern in the balance between reproductive benefits and risks. AIM: To evaluate the ovarian reserve in sub fertile women after laparoscopic endometriotic cystectomy. SETTINGS AND DESIGN: Prospective study, done in Department of Obstetrics and Gynecology, tertiary care hospital between August 2010-2012. MATERIALS AND METHOD: Laparoscopic cystectomy performed by stripping technique for endometriotic cysts. Endometriosis was staged according to revised American Society of Reproductive Medicine classification (rASRM). Ovarian reserve assessed by comparing FSH and LH levels, measurement of residual ovarian volume, antral follicle counts and stromal blood flow on second day of menses pre and postoperatively. Cyst wall was evaluated histologically to note the presence of normal ovarian tissue in resected tissue. STATISTICAL ANALYSIS: SPSS for Windows version 16.0 (SPSS Inc., Chicago, IL) was used for statistical calculations. Wilcoxon signed test and Pearson Chi – Square test were applied. Significance level was P < 0.05. RESULTS: Incidence of minimal, mild, moderate, and severe endometriosis was 4.1%, 21.9%, 28.7%, 45.3% respectively. Ovarian reserve was assessed both by ultrasound and biochemical parameters on day 2 of menses; pre and post-operatively. Preoperative and post-operative values; FSH (7.24 ± 1.21, 7.23 ± 1.51 m IU/ml), LH levels (6.37 ± 1.8, 6.6 ± 2.3 m IU/ml), residual ovarian volume (8.5 cm3 ± 5.3, 7.4 cm3 ± 5.8), antral follicle count(3.3 ± 1.9, 4.1 ± 1.5) and stromal blood flow (6.8 cm/sec ± 4.57, 7.1 cm/sec ± 3.55) were statistically not significant. Loss of follicle was seen in 27.2% cyst walls on histopathological examination while 72.73% had no loss. CONCLUSION: Laparoscopic cystectomy when performed for endometriotic cysts with accurate surgical technique leads to no significant ovarian tissue removal.
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Affiliation(s)
- Rajeshwari G Bhat
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Sushma Dhulked
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Amar Ramachandran
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Rajesh Bhaktha
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Akhila Vasudeva
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Pratap Kumar
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Anuradha C K Rao
- Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Ahmed S, Pahwa S, Das CJ, Mir FA, Nisar S, Jehangir M, Parveen S, Rashid A, Ganie MA. Comparative evaluation of sonographic ovarian morphology of Indian women with polycystic ovary syndrome versus those of normal women. Indian J Endocrinol Metab 2014; 18:180-4. [PMID: 24741513 PMCID: PMC3987267 DOI: 10.4103/2230-8210.129108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To study ovarian morphology by ultrasound in women with or without polycystic ovary syndrome (PCOS) and to establish cut-off values of these parameters in Indian women with PCOS. MATERIALS AND METHODS A total of 119 consecutive women diagnosed PCOS and 77 apparently healthy women were enrolled. Transabdominal ultrasound examination was carried out to assess ovarian volume, stromal echogenecity, follicle number and size. Cut-off values of the above ovarian parameters with sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were calculated. RESULTS Sensitivity of 79.49% and specificity of 90.67% was achieved with a cut-off of 8 mL as ovarian volume. A cut-off value of 9 follicles to distinguish between PCOS and control women yielded a sensitivity of 82.35% and specificity of 92.0% while as a follicular size of 5 mm yielded sensitivity and specificity of 74.67% and 78.15% respectively. With all the three parameters sensitivity was 87.39% and specificity 87.84% with 92.04% PPV and 81.25% NPV. CONCLUSION Using two or three sonographic criteria in combination improves sensitivity and helps diagnose additional patients with PCOS. Our results are at variance with the established cut-off values highlighting the fact that American Society for Reproductive Medicine consensus cut-off values are not reproducible in Indian context.
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Affiliation(s)
- Sanjeed Ahmed
- Department of Radiodiagnosis, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Shivani Pahwa
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Chandan Jyoti Das
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Farooq A Mir
- Department of Radiodiagnosis, Sheri-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Sobia Nisar
- Department of Geriatric Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Majid Jehangir
- Department of Radiodiagnosis, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Shameem Parveen
- Department of Obstetrics and Gynecolgy, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Aafia Rashid
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Mohd Ashraf Ganie
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Leonhardt H, Gull B, Stener-Victorin E, Hellström M. Ovarian volume and antral follicle count assessed by MRI and transvaginal ultrasonography: a methodological study. Acta Radiol 2014; 55:248-56. [PMID: 23926234 DOI: 10.1177/0284185113495835] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Ultrasonographic measurements of ovarian volume and antral follicle count are of clinical importance as diagnostic features of polycystic ovarian syndrome (PCOS), and as a parameter in estimation of ovarian follicular reserve in infertility care. PURPOSE To compare two-dimensional (2D)/three-dimensional (3D) transvaginal ultrasonography (TVUS) and magnetic resonance imaging (MRI) for estimation of ovarian volume and antral follicle count, and to assess reproducibility and inter-observer agreement of MRI measurements. MATERIAL AND METHODS Volumes of 172 ovaries in 99 women aged 21-37 years were calculated (length x width x height x 0.523) with conventional 2D TVUS and 2D MRI. Semi-automatic estimates of ovarian volumes were obtained by 3D MRI. Antral follicles were counted manually on 2D MRI and automatically by 3D TVUS (SonoAVC), and stratified according to follicle size. RESULTS Mean ovarian volume assessed by 2D TVUS (13.1 ± 6.4 mL) was larger than assessed by 2D MRI (9.6 ± 4.1) and 3D MRI (11.4 ± 4.5) (P < 0.001). Total follicle count was higher by 2D MRI than by 3D TVUS, mean difference 14.3 ± 16.2 follicles (P < 0.001). In the smallest size interval of 1-3 mm the mean difference was 22.2 ± 17.6 (P < 0.001). Intra- and inter-observer absolute agreement assessment for MRI measurements of ovarian volume and total follicle count showed ICC coefficients >0.77. CONCLUSION 2D MRI reveals more antral follicles, especially of small size, than 3D TVUS. Ovarian volume estimation by MRI provides smaller volumes than by the reference standard 2D TVUS. Ovarian volume estimation by 3D MRI, allowing independence of non-ellipsoid ovarian shape measurement errors, provides volumes closer to 2D TVUS values than does 2D MRI. Reproducibility and inter-observer agreement of 2D MRI measurements of ovarian volume and total follicle count are good.
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Affiliation(s)
- Henrik Leonhardt
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Berit Gull
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Elisabet Stener-Victorin
- Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Hellström
- Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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28
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Souter I, Smith KW, Dimitriadis I, Ehrlich S, Williams PL, Calafat AM, Hauser R. The association of bisphenol-A urinary concentrations with antral follicle counts and other measures of ovarian reserve in women undergoing infertility treatments. Reprod Toxicol 2013; 42:224-31. [PMID: 24100206 DOI: 10.1016/j.reprotox.2013.09.008] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 09/18/2013] [Accepted: 09/25/2013] [Indexed: 10/26/2022]
Abstract
In this prospective cohort of women undergoing infertility treatments, we measured specific-gravity adjusted urinary BPA (SG-BPA) concentrations and used regression models to evaluate the association of BPA with antral follicle count (AFC), day-3 serum follicle stimulating hormone levels (FSH), and ovarian volume (OV). BPA, detected in >80% of women, had a geometric mean (±GSD) of 1.6±2.0, 1.7±2.1, and 1.5±1.8μg/L for the women contributing to the AFC (n=154), day-3 FSH (n=120), and OV (n=114) analyses, respectively. There was an average decrease in AFC of 12% (95% CI: -23%, -0.6%), 22% (95% CI: -31%, -11%), and 17% (95% CI: -27%, -6%), in the 2nd, 3rd, and 4th SG-BPA quartile compared to the 1st quartile, respectively (p-trend: <0.001). No association of SG-BPA with FSH or OV was observed. Among women from an infertility clinic, higher urinary BPA concentrations were associated with lower AFC, raising concern for possible accelerated follicle loss and reproductive aging.
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Affiliation(s)
- Irene Souter
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Harvard Medical School/Massachusetts General Hospital Fertility Center, Yawkey 10-A, 55 Fruit Street, Boston, MA 02114, USA.
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Koutlaki N, Dimitraki M, Zervoudis S, Poiana C, Psillaki A, Nikas I, Liberis A, Badiu C, Liberis V. The relationship between Anti-Müllerian hormone and other reproductive parameters in normal women and in women with polycystic ovary syndrome. J Med Life 2013; 6:146-50. [PMID: 23904873 PMCID: PMC3725438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 04/08/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To correlate Anti-Müllerian hormone (AMH) levels with years since menarche as well as to investigate the AMH relationship with ovarian morphology and levels of androgens in healthy normo- ovulatory women and in women with polycystic ovary syndrome (PCOS). DESIGN Prospective clinical study. SETTING University Hospital of Alexandroupolis, Lito Maternity Hospital. PATIENTS Forty two healthy normo-ovulatory women and sixty one women with PCOS, recruited on the basis of the classic PCOS criteria (Rotterdam consensus meeting definition of PCOS (ESHRE/ASRM, 2004). INTERVENTIONS Fasting blood was obtained from all subjects in the early follicular phase (days 5-6) after spontaneous or induced menses (in PCOS), and transvaginal ultrasound examination was performed. MAIN OUTCOME MEASURES Assessment of values for follicular stimulating hormone (FSH), testosterone (T), AMH, as well as assessments of years since menarche and ovarian volume. RESULTS AMH had a statistically significant positive correlation with the ovarian volume (r =0,623, r =0,579 P<0.01) and negative correlation with years since menarche (r =-0,766, r =-0,796 (P<0.01). In women with PCOS, AMH and years since menarche had a significant correlation with testosterone (r =0,477, r = -0,527, P<0.01) CONCLUSIONS: This study underlines the relation between AMH and years since menarche as well as the AMH differences in relation with certain clinical or endocrine characteristics between normal and PCOS women.
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Affiliation(s)
- N Koutlaki
- Department of Obstetrics and Gynecology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece.
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Adibi A, Mardanian F, Hajiahmadi S. Comparison of Ovarian volume and Antral follicle count with Endocrine tests for prediction of responsiveness in ovulation induction protocols. Adv Biomed Res 2012; 1:71. [PMID: 23326801 PMCID: PMC3544132 DOI: 10.4103/2277-9175.102975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 05/15/2012] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The aim of this study was to determine if the basal antral follicle number and ovarian volume contributes to the prediction of responsiveness in ovulation induction protocol and comparison of it with hormonal tests. MATERIALS AND METHODS 52 irregularly-menstruating patients, aged 18-46 years, participated in this prospective study. All the patients underwent a transvaginal sonography to measure the basal ovarian volume and the basal antral follicles count (AFC). Clomiphene citrate challenge test was measured by summation of measurements of FSH on day 2 and 10. All the women received clomiphene citrate from day 2 to 6. Ovarian responsiveness was measured 1 week after termination of clomiphene citrate and was used as gold standard. RESULTS Multiple regression analysis revealed that AFC was the only significant factor for ovarian responsiveness prediction. The area under the curve for AFC to discriminate responder ovaries was 0.66 (95% confidence interval, 0.87-0.99). The cutoff value for predicting ovarian responsiveness was 15.5. CONCLUSION AFC can contribute to the prediction of responsiveness in ovulation induction protocol better than ovarian volume and hormonal tests.
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Affiliation(s)
- Atoosa Adibi
- Radiology Department, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Atoosa Adibi, Associate Professor of Radiology, Radiology Department, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Farahnaz Mardanian
- Obstetrics and Gynecology Department, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somaye Hajiahmadi
- Radiology Department, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
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31
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Farimani Sanoee M, Neghab N, Rabiee S, Amiri I. Metformin therapy decreases hyperandrogenism and ovarian volume in women with polycystic ovary syndrome. Iran J Med Sci 2011; 36:90-5. [PMID: 23358726 PMCID: PMC3556752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 08/15/2010] [Accepted: 11/11/2010] [Indexed: 11/04/2022]
Abstract
BACKGROUND It is well known that there is a close relationship between elevated androgen plasma levels and the ultrasound findings of stromal hypertrophy in polycystic ovary syndrome (PCOS). The objective of this study was to investigate the effects metformin on the hyperandrogenism and ovarian volume in PCOS. METHODS The study is an unrandomized clinical trial with before-after design. Twenty eight patients with infertility (male or female factor) meeting the Rotterdam ESHRE/ASRM criteria for PCOS were studied during the 2008-2009. The anthropometric characteristics of the patients, mean bilateral ovarian volume, and morphology by trans vaginal sonography as well as the plasma levels of leutinizing hormone, follicle stimulating hormone, estradiol, testosterone, 17-α-hydroxyprogesterone, and dehydroepianderosterone sulfate were obtained before and after treatment with metformin (500 mg three times a day) for three months. Paired t, Pearson's Correlation Coefficient, or Partial Correlation test was used to analyze the findings. RESULTS The patients had a mean age of 25.67 years. A significant reduction in mean ovarian volume (11.70±4.31 ml vs 8.27±3.71 ml P=0.001), body mass index (BMI, 28.11±4.55 kg/m(2) vs 26.84±4.55 kg/m(2) P=0.000) and serum androgen levels was seen after three months of treatment with metformin. There was positive correlations between the ovarian volume and serum testosterone level (r=0.589, P=0.001) or BMI (r=0.663, P=0.000). CONCLUSION Metformin therapy may lead to a reduction in ovarian volume. It is likely that the reduction of ovarian volume reflect a decrease in the mass of androgen producing tissues. TRIAL REGISTRATION NUMBER IRCT138903244176N1.
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Affiliation(s)
- Marzieh Farimani Sanoee
- Department of Obstetrics and Gynecology, Fatemieh Hospital, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Nosrat Neghab
- Department of Obstetrics and Gynecology, Fatemieh Hospital, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Soghra Rabiee
- Department of Obstetrics and Gynecology, Fatemieh Hospital, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Iraj Amiri
- The Center for Molecular Medicine Research, Hamedan University of Medical Sciences, Hamedan, Iran
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Abstract
PURPOSE Recently ovarian volume has been touted as a means to evaluate ovarian reserve in assisted reproductive technology cycles. In this study, a novel method of determining ovarian size was evaluated and compared to the standard three-dimensional ovarian volume measurement during in vitro fertilization (IVF). METHODS This prospective observational study consisted of 60 consecutive patients undergoing baseline transvaginal ultrasonography for IVF from July to August, 1999. The main outcome measures were mean ovarian size and mean ovarian volume. RESULTS The patients' ages ranged from 23 to 43 years with a mean age of 33.86 +/- 4.5 years. The mean ovarian size was 2.19 +/- 0.4 cm (range 1.40-3.40). The mean ovarian volume was 5.02 +/- 2.7 cm3 (range 1.71-16.5 cm3). By linear regression there was a 90% correlation between the two methods of ovarian measurement (r = 0.90, p < 0.01). CONCLUSIONS These results demonstrated a strong correlation between these two methods of determining ovarian size. Mean ovarian diameter measured in the largest sagittal plane is a good estimation of ovarian volume and may be used to quickly assess ovarian status prior to undergoing IVF.
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Affiliation(s)
- John L Frattarelli
- Department of Obstetrics and Gynecology, Tripler Army Medical Center, Honolulu, Hawaii 96859, USA
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