Polycystic ovarian morphology in postmenarchal adolescents
Polycystic ovarian morphology in postmenarchal adolescents
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DOI：
10.1016/j.fertnstert.2010.06.015
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发表时间：
2011-02-01
影响因子：
6.7
通讯作者：
Cassorla, Fernando
中科院分区：
文献类型：
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作者：
Codner, Ethel;Villarroel, Claudio;Cassorla, Fernando
目的：探讨多囊卵巢形态与青少年卵巢功能的关系，并确定其随访两年的时间进程。设计：前瞻性研究。地点：学术中心。患者(S)：20名健康青少年，月经后2~4年。干预(S)：每年一次的超声和激素检查。通过测定唾液孕酮水平来评估排卵情况。主要结果(S)：月经后持续PCOM；PCOM女孩排卵。结果(S)：PCOM在月经初潮2、3和4年的超声检查中分别占40%、35%和33.3%。绝经后2年和4年超声诊断的符合率(50%)无显著差异(kappa=0.08)。PCOM与排卵率、月经周期持续时间、血脂水平或胰岛素抵抗的稳态模型评估的异常无关。PCOM组的FSH(4.8+/-1.3)明显低于非PCOM组(6.1+/-1.9 MU/ml)。在亮丙瑞林试验中，患有PCOM和不患有PCOM的女孩的睾酮和17-羟孕酮水平相似。结论：PCOM在健康青少年中是一种不稳定的发现，与健康青少年排卵率下降或代谢异常无关。这一发现表明，PCOM可能与青春期早期的一种生理状况相对应。(Fertil Steril(R)2011；95：702-6。(C)2011年，由美国生殖医学会提供。)
Objective: To evaluate the association of polycystic ovary morphology (PCOM) with ovarian function in adolescents and to determine its time course during two years of follow-up.Design: Prospective study.Setting: Academic center.Patient(s): Twenty healthy adolescents were followed from 2-4 years after menarche.Intervention(s): We performed annual ultrasonographic and hormonal studies. Ovulation was assessed during 6 consecutive months by measuring salivary progesterone levels.Main Outcome Measure(s): Persistence of PCOM during the years following menarche; ovulation in girls with PCOM.Result(s): PCOM was observed in 40%, 35%, and 33.3% of the ultrasonographic studies performed at 2, 3, and 4 years after menarche, respectively. The concordance between ultrasonographic diagnosis at 2 and 4 years postmenarche (50%) was nonsignificant (kappa = 0.08). PCOM was not associated with abnormalities in ovulatory rate, menstrual cycle duration, lipid levels, or homeostatic model assessment of insulin resistance. However, lower FSH (4.8 +/- 1.3 vs. 6.1 +/- 1.9 mUI/ml) were observed in girls with PCOM compared with those without PCOM. Similar T and stimulated 17-hydroxyprogesterone on the leuprolide test were observed in girls with and without PCOM.Conclusion(s): PCOM is an inconstant finding in healthy adolescents and does not appear to be associated with decreased ovulatory rate or metabolic abnormalities in healthy adolescents. This finding suggests that PCOM may correspond to a physiologic condition during early adolescence. (Fertil Steril(R) 2011;95:702-6. (C) 2011 by American Society for Reproductive Medicine.)