Trajectory of ovarian morphology during the adolescent reproductive transition.

项目总结。女性青春期生殖成熟的干扰可能会持续 对未来健康和疾病的影响。建立有规律的月经周期是 生殖成熟和公认的健康和福祉的重要迹象。月经周期可 在妇科早期是不可预测的。因此，生殖疾病的诊断和干预 骚乱通常会在月经初潮后推迟几年。关于青少年的有限数据 生殖过渡阻碍了识别早期标记的能力，这些标记可能预测潜在的 生殖障碍。卵巢形态可能是一种可行和方便的生物标志物，因为已知 为诊断、评估和治疗生殖障碍提供信息的能力在相对非 侵犯性的方式。新的经腹超声提供的改进的图像质量和分析工具 (Taus)技术现在可以实现对卵巢特征的可靠和全面的表征 跨越青春期。卵巢形态在转变为 有规律的月经与持续的月经不规律可以作为识别女孩未来风险的基础 生殖障碍及其相关的合并症。该项目旨在确定一项 治疗后头2年青少年卵巢形态的前瞻性纵向TAUS评估 月经初潮。我们的方法包括使用二维(2D)和三维(3D)TaU来对比 正常和不规则月经周期青少年1年的卵巢形态轨迹。这个 有待检验的主要假说是卵巢形态的变化与建立 有规律的月经周期和卵巢形态的不同方面可以预测 有规律的月经与持续的周期不规律相比。这项建议与以下优先领域一致 国家儿童健康与人类研究所生育与不孕部概述的研究 开发(NICHD)，因为它努力开发创新工具，以非侵入性地评估正常和异常 青春期生殖过渡的形态特征。这项研究的发现将 立即完善超声在卵巢形态临床评估中的应用 可以使用2D或3D TAUS在青少年中可靠地评估卵巢形态的各个方面。 此外，该项目将作为更大的纵向队列研究的基础，旨在充分说明 卵巢形态在正常和异常生殖发育中的进展是至关重要的 用于识别未来生殖障碍和疾病的早期超声生物标记物。

PROJECT SUMMARY. Perturbations in reproductive maturation during female adolescence may have lasting consequences on future health and disease. Establishment of regular menstrual cycles is a key component of reproductive maturation and a recognized vital sign for health and well-being. Menstrual cyclicity can be unpredictable in the early gynecological years. Therefore, diagnosis and intervention of reproductive disturbances are commonly delayed for several years post-menarche. Limited data on the adolescent reproductive transition has hampered the ability to identify early markers that might predict underlying reproductive disorders. Ovarian morphology may represent a viable and convenient biomarker given its known ability to inform the diagnosis, evaluation and treatment of reproductive disorders in women in a relatively non- invasive manner. The improved image quality and analysis tools afforded by new transabdominal ultrasound (TAUS) technology may now enable the reliable and comprehensive characterization of ovarian characteristics across adolescence. A demonstration of distinct trajectories in ovarian morphology during the transition to regular menses versus sustained cycle irregularity may serve as a basis for identifying girls at risk for future reproductive disorders and its associated comorbidities. This project aims to establish the feasibility of a prospective longitudinal TAUS assessment of ovarian morphology in adolescents during the first 2 years post- menarche. Our approach involves the use of both two- (2D) and three-dimensional (3D) TAUS to contrast the trajectory of ovarian morphology in adolescents with regular and irregular menstrual cycles for 1 year. The main hypotheses to be tested are that ovarian morphology changes in association with the establishment of regular menstrual cycles and that there are distinct aspects of ovarian morphology that predict the likelihood of regular menses compared to persistent cycle irregularity. This proposal is consistent with prioritized areas of research outlined by the Fertility and Infertility Branch of the National Institute of Child Health and Human Development (NICHD) as it strives to develop innovative tools to non-invasively evaluate normal and abnormal morphologic characteristics of the adolescent reproductive transition. The findings of this research will immediately refine the utility of ultrasound in the clinical evaluation of ovarian morphology by identifying aspects of ovarian morphology that can be reliably assessed in adolescents using either 2D or 3D TAUS. Further, this project will serve as the basis for a larger longitudinal cohort study aimed at fully characterizing the progression of ovarian morphology during normal and abnormal reproductive development which is critical for identifying early sonographic biomarkers for future reproductive disturbance and disease.