Significance of ovarian histology in the management of patients presenting a premature ovarian failure

Massin, Nathalie; Gougeon, Alain; Meduri, Géri; Thibaud, E; Laborde, Kathleen; Matuchansky, C; Constancis, E.; Vacher-Lavenu, Marie-Cécile; Paniel, B. J.; Zorn, J. R.; Misrahi, Micheline; Kuttenn, Frédérique; Touraine, P.

doi:10.1093/humrep/deh461

Cited by 63 publications

(58 citation statements)

References 21 publications

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“…We previously demonstrated that AMH levels in POF patients could identify women with persistent small follicles (35), but the value of serum AMH monitoring in POF has to be further evaluated in prospective studies. Unlike other authors (36, 37), we concluded, on the basis of our previous and current studies, that ovarian histology appears to be a more reliable tool in evaluating the follicular reserve (20). Indeed, the comparison of follicular pattern at pelvic ultrasonography and at ovarian biopsy confirms our previous data (20).…”

Section: Discussionsupporting

confidence: 83%

“…Unlike other authors (36, 37), we concluded, on the basis of our previous and current studies, that ovarian histology appears to be a more reliable tool in evaluating the follicular reserve (20). Indeed, the comparison of follicular pattern at pelvic ultrasonography and at ovarian biopsy confirms our previous data (20). In 47 patients, images suggesting the presence of follicles were observed at ultrasonography.…”

Section: Discussionsupporting

confidence: 81%

“…This may lead to a distinction between two different situations: the absence of follicles is likely to be due to a molecular defect of the genes involved in oogenesis, the formation of the ovarian reserve or apoptosis, while the presence of follicles whose maturation has been blocked is due to defects of the genes involved in follicular growth (34). Plasma levels of E 2 , inhibin B, and AMH are of limited value in predicting the presence of an ovarian reserve in patients with POF (20), but in the present study E 2 and inhibin B correlated well with the presence of follicles at ultrasonography. We previously demonstrated that AMH levels in POF patients could identify women with persistent small follicles (35), but the value of serum AMH monitoring in POF has to be further evaluated in prospective studies.…”

Section: Discussionmentioning

confidence: 99%

“…When available, the surface area of the ovaries was calculated as: SZL (length)!W (width)!0.8. The normal surface area of the ovary ranges between 2 and 6 cm 2 (20).…”

Section: Pelvic Ultrasonographymentioning

confidence: 99%

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Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure

Bachelot

Rouxel²,

Massin³

et al. 2009

European Journal of Endocrinology

128

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Objective: Premature ovarian failure (POF) encompasses a heterogeneous spectrum of conditions, with phenotypic variability among patients. The etiology of POF remains unknown in most cases. We performed a global phenotyping of POF women with the aim of better orienting attempts at an etiological diagnosis. Design and methods: We performed a mixed retrospective and prospective study of clinical, biological, histological, morphological, and genetic data relating to 357 consecutive POF patients between 1997 and 2008. The study was conducted at a reproductive endocrinology referral center. Results: Seventy-six percent of the patients presented with normal puberty and secondary amenorrhea. Family history was present in 14% of the patients, clinical and/or biological autoimmunity in 14.3%. Fifty-six women had a fluctuating form of POF. The presence of follicles was suggested at ultrasonography in 50% of the patients, and observed in 29% at histology; the negative predictive value of the presence of follicles at ultrasonography was 77%. Bone mineral density alterations were found in 58% of the women. Eight patients had X chromosomal abnormalities other than Turner's syndrome, eight other patients evidenced FMR1 pre-mutation. Two other patients had autoimmune polyendocrine syndrome type 2 and 1. Conclusion: A genetic cause of POF was identified in 25 patients, i.e. 7% of the whole cohort. POF etiology remains most often undiscovered. Novel strategies of POF phenotyping are in such content mandatory to improve the rate of POF patients for whom etiology is identified.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

“…When available, the surface area of the ovaries was calculated as: SZL (length)!W (width)!0.8. The normal surface area of the ovary ranges between 2 and 6 cm 2 (20).…”

Section: Pelvic Ultrasonographymentioning

confidence: 99%

See 2 more Smart Citations

Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure

Bachelot

Rouxel²,

Massin³

et al. 2009

European Journal of Endocrinology

128

View full text Add to dashboard Cite

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“…Por outro lado, o papel da biópsia ovariana, no diagnóstico e prognóstico da FOP, é controverso e há relatos de gestações ocorridas em pacientes com biópsia negativa (22). A biópsia ovariana com ausência de folículo pode refletir apenas uma amostra inadequada de tecido, assim como a presença deles não implicar numa resposta positiva ao tratamento (44).…”

Section: Diagnósticounclassified

Falência ovariana prematura: aspectos atuais

Vilodre

Moretto

Kohek

et al. 2007

Arq Bras Endocrinol Metab

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RESUMOA falência ovariana prematura (FOP) acomete aproximadamente 1:1000 mulheres antes dos 30 anos, 1:250 em torno dos 35 anos e de 1:100 aos 40 anos. Manifesta-se como amenorréia primária ou amenorréia secundária, não podendo ser considerada definitiva em todas as pacientes, uma vez que a concepção espontânea pode ocorrer em até 5-10% das FOP. Na maioria dos casos apresenta-se na forma esporádica, pois apenas 5% apresentam história familial. Entre as causas conhecidas estão as alterações cromossômicas, dos genes ligados ao cromossomo X e cromossomos autossômicos, doenças autoimunes, alterações tóxicas e iatrogênicas. Com relativa freqüência, a causa etiológica não é obtida, sendo então denominada de idiopática. O diagnóstico da FOP é feito baseado na história clínica e níveis elevados do hormônio folículo estimulante (FSH), sendo posteriormente investigadas as causas mais específicas. O manejo clínico visa o suporte emocional, o tratamento hormonal com estrogênios e progestogênios, a abordagem da infertilidade e a prevenção de co-morbidades como a osteoporose e potencial maior risco cardiovascular. It is characterized by primary or secondary amenorrhea and cannot be considered as definitive because spontaneous conception may occur in 5 to 10% of cases. In 95% of cases, premature ovarian failure is sporadic. The known causes of premature ovarian failure include chromosomal defects, autoimmune diseases, exposure to radiation or chemotherapy, surgical procedures, and certain drugs. Frequently, however, the etiology is not clear and these cases are considered to be idiopathic. Premature ovarian failure is defined by gonadal failure and high serum follicle-stimulating hormone (FSH) levels. Clinical approach includes emotional support, hormonal therapy with estrogens and progesterone or progestogens, infertility treatment, and prevention of osteoporosis and potential cardiovascular risk.

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Premature Ovarian Failure

Sundblad¹,

Chiauzzi²

Contemporary Endocrinology

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Significance of ovarian histology in the management of patients presenting a premature ovarian failure

Abstract: Ovarian histology appears to be a reliable tool in evaluating the follicular reserve, and helpful and complementary to clinical and hormonal phenotyping in orienting the search for the various genetic causes of POF syndrome.

Cited by 63 publications

References 21 publications

Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure

Phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure

Falência ovariana prematura: aspectos atuais

Premature Ovarian Failure

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