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Background/Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of fertile age. Some studies suggest that a ketogenic diet (KD) may have a role in treating PCOS. We aimed to demonstrate the long-term effectiveness of a KD in PCOS. Methods: Eighteen patients with PCOS phenotype A were enrolled: 28% were of normal weight, 28% were overweight, and 44% had obesity. All participants followed a KD without meal replacements for 45 days. After this period, patients underwent gradual carbohydrate reintroduction over 45 days, and thereafter healthy eating indications were given. Twelve patients completed the study. The patients were assessed at baseline and after 6 months. Anthropometric data, body composition, pelvic ultrasound, blood chemistry, hirsutism, and menstrual cycles frequency were recorded; Results: Besides improvement in anthropometric parameters, menstrual cycles (p 0.012), ovarian volume (p 0.029), FSH (p 0.05), LH (p 0.037), and progesterone (p 0.017) improved independently of weight or fat loss. However, testosterone and hirsutism improvements were influenced by weight and fat mass reduction. Conclusions: Our study showed that a KD followed by gradual carbohydrate reintroduction in PCOS has beneficial effects medium term, mostly independent of body weight loss, even in normal-weight women, suggesting that nutritional ketosis exerts beneficial effects per se. [ABSTRACT FROM AUTHOR]

The polycystic ovarian morphology (PCOM) is a generally accepted ultrasound marker for ovulatory dysfunction, is one of the criteria for polycystic ovary syndrome (PCOS) and is established based on the assessment of ovarian volume (OV) and the follicle number per ovary (FNPO), taking into account the upper normal values determined in healthy premenopausal women. However, there is a necessity for regular revision of the PCOM characteristics depending on ethnic and age characteristics.The aim. To develop differentiated standards for assessing the ultrasonographic ovary structure in premenopausal women of various ethnicity.Materials and methods. From March 2016 to December 2019, a multicenter cross-sectional prospective study was conducted in Eastern Siberia (Irkutsk region) and in the neighboring Republic of Buryatia. The study included 1134 participants: 715 women of Caucasian origin, 312 Asian women, 107 women of mixed ethnic subpopulation.Results. It has been established that for Caucasians, it is advisable to diagnose PCOM when the ovarian volume is 9 cm3 and/or FNPO ≥ 12; for women of the Asian population – when the ovarian volume is 7 cm3 and/or FNPO ≥ 11; for women of mixed ethnicity – when the ovarian volume is 8 cm3 and/or FNPO ≥ 9. An important advantage of our study is that all participants were recruited from a non-selective multi-ethnic population of women with comparable socio-demographic characteristics living in the same geographical conditions.Conclusion. Differentiated approach for identifying the polycystic ovarian morphology in premenopausal women of different ethnic groups requires using ethnically differentiated normative readings

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. [ABSTRACT FROM AUTHOR]

Background/Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of fertile age. Some studies suggest that a ketogenic diet (KD) may have a role in treating PCOS. We aimed to demonstrate the long-term effectiveness of a KD in PCOS. Methods: Eighteen patients with PCOS phenotype A were enrolled: 28% were of normal weight, 28% were overweight, and 44% had obesity. All participants followed a KD without meal replacements for 45 days. After this period, patients underwent gradual carbohydrate reintroduction over 45 days, and thereafter healthy eating indications were given. Twelve patients completed the study. The patients were assessed at baseline and after 6 months. Anthropometric data, body composition, pelvic ultrasound, blood chemistry, hirsutism, and menstrual cycles frequency were recorded; Results: Besides improvement in anthropometric parameters, menstrual cycles (p 0.012), ovarian volume (p 0.029), FSH (p 0.05), LH (p 0.037), and progesterone (p 0.017) improved independently of weight or fat loss. However, testosterone and hirsutism improvements were influenced by weight and fat mass reduction. Conclusions: Our study showed that a KD followed by gradual carbohydrate reintroduction in PCOS has beneficial effects medium term, mostly independent of body weight loss, even in normal-weight women, suggesting that nutritional ketosis exerts beneficial effects per se.

Background: Hysterectomy is the commonest gynecological surgery in females. The aim of this study was to assess the effect of doing hysterectomy with ovarian conservation on the ovarian function. Methods: It was an observational cross-sectional study which was conducted in the department of obstetrics and gynecology, Zagazig University Hospitals on 80 cases scheduled to undergo hysterectomy with ovarian preservation due to benign condition during the period from August 2015 to August 2018. Participants were subjected to assessment of ovarian function by ultrasonographic assessment of ovarian volume, morphology and hormonal levels pre-operative and postoperative. The research was accepted by the Institutional Review Board of the Faculty of Medicine in Zagazig University. The research was done according to the Code of Ethics of the World Medical Association (Declaration Helsinki) for Studies involving humans. Results: There was a statistically non-significant decrease in FSH level preoperatively to one month postoperatively that significantly increased again three months postoperatively.. There was a non-significant difference between right ovarian volume preoperatively and one month postoperatively. There was a significant difference between right ovarian volume preoperatively and three months postoperatively. Conclusions: we concluded that there was no evidencve of adverse effect on the ovarian function of the conserved ovaries 3 months after doing hysterectomy in premenopausal patients as by hormonal and U/S criteria. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objectives: Ovarian torsion is a gynecologic emergency that can cause loss of ovarian function. The aim of the study was to evaluate the ovarian reserve of the patients who were operated for detorsion because of ovarian torsion. Materials and Methods: The medical records of the patients who underwent detorsion for ovarian torsion in our clinic between January 2013 and June 2017 were investigated. Ovarian reserve parameters including ovarian volume, antral follicle count and ovarian artery resistance index (RI) were evaluated by ultrasonography in post-operational period. Patients that had oophorectomy due to torsion or who had another ovarian surgery before or after torsion and pregnant women were not included in the study. The ovarian volume, antral follicle count and ovarian artery RI in the operated side were compared with the contralateral ovary. Results: Thirty-four women meeting the inclusion criteria were examined by ultrasonography in the early follicular phase of their cycles. Antral follicle count, ovarian volume and ovarian artery RI were decreased significantly (p<0.001, p<0.001 and p<0.001, respectively) in the operated ovary compared to the contralateral ovary. Sixteen patients who were treated by detorsion, underwent cystectomy at the same time. No significant difference was observed in ovarian reserve of the patients who had cystectomy together with detorsion compared to those who were operated only with detorsion. Conclusion: Antral follicle count, ovarian volume and ovarian artery RI were significantly decreased after detorsion operation in the operated side compared to the contralateral ovary. [ABSTRACT FROM AUTHOR]

Abstract Objective In this study, patients were divided into two groups. Patients with polycystic ovary syndrome (PCOS) and patients with polycystic ovary syndrome + Hashimoto's Thyroid (PCOS + HT). The effect of insulin resistance on ovarian volume in patients divided into two groups and the change in ovarian volume with the addition of HT to PCOS will be investigated. Material and methods 46 PCOS patients and 46 PCOS patients diagnosed with HT were included in this study. A detailed medical history was taken from all participants. Polycystic ovary image was evaluated as below or above 10 ml and antral follicles were counted by transvaginal ultrasound. Insulin resistance of the patients was evaluated according to the fasting insulin (HOMA) index. Results Insulin resistance was found to be associated with fasting insulin, HOMA index, body mass index and right ovarian volume in patients diagnosed with PCOS. Among the patients diagnosed with PCOS + HT, insulin resistance was found to be significantly correlated with fasting insulin, HOMA index, (BMI), (SHBG) and left ovarian volume. An increase in right ovarian volume was found in 37.5% of patients with PCOS without insulin resistance and in 76.3% of patients with insulin resistance. An increase in left ovarian volume was found in 35.7% of patients without insulin resistance diagnosed with PCOS + HT and in 68.8% of patients with insulin resistance. Conclusions This study shows that ovarian volume should be evaluated in every PCOS patient in order to predict insulin resistance, which causes long-term metabolic diseases, and that all PCOS patients with increased ovarian volume should be investigated for insulin resistance. In addition, it has been observed that insulin resistance affects left ovarian volume in patients with PCOS + HT, whereas insulin resistance affects the volume of the right ovary more in patients with PCOS. At least one ovary has been found to be affected by long-term metabolic diseases. While there was a greater increase in ovarian volume with the addition of insulin resistance, no significant change was observed in the number of patients with increased ovarian volume (PCOS-58, PCOS + HT-57) with the addition of HT finding.

Abstract Background Polycystic ovary syndrome (PCOS) is diagnosed based on chronic anovulation, androgen excess (clinical and/or biochemical), and polycystic ovaries in ultrasound. The aim of the present study was to evaluate which parameters in the transvaginal ultrasound (TVUS) of ovaries could be better associated with concurrent hormonal imbalance in the women with PCOS. Methods Using a cross-sectional design, this study focused on 61 subjects (18–40 years) with PCOS. Patients were recruited at three academic hospitals during the 2017–2019 period. PCOS was defined according to the Rotterdam criteria. The association of ovarian morphology with hormonal and metabolic feature was investigated using linear regression models, adjusted for a set of possible confounding variables including age, mensuration status and body mass index (BMI). Results The mean volume of both ovaries was positively associated with the total testosterone level (β = 0.025, P value

Objective: To determine whether ovarian volume (OV) alone is an independent marker for metabolic dysfunction in women with suspected androgen excess. Design: Retrospective cohort study. Setting: Tertiary academic reproductive endocrinology clinic. Patient(s): Women aged ≥21 years recruited/referred for symptoms related to androgen excess. Intervention(s): Transvaginal ovarian ultrasound, physical and medical evaluation, 2-hour 75-g oral glucose tolerance test (oGTT), and blood sampling. Main Outcome Measure(s): Prevalence of hyperandrogenism and metabolic dysfunction. Result(s): This study included 666 women, of whom 412 (61.9%) and 254 had OVs of >10 and ≤10 mL, respectively. An OV of >10 mL was associated with a higher prevalence of hirsutism (65.1% vs. 51.5%) than an OV of ≤10 mL. Polycystic ovary syndrome by the National Institutes of Health 1990 criteria was found in 67.3% and 51.4% of women with OVs of >10 and ≤10 mL, respectively. Metabolic parameters, including body mass index, waist circumference, and 1-hour insulin levels during the oGTT (odds ratio, 1.98; 95% confidence interval, 1.18–3.31), were significantly higher in women with an OV of >10 mL than in those with an OV of ≤10 mL. An OV of ≤10 mL had a 76.3% negative predictive value for hyperinsulinemia at 1 hour. Conclusion(s): In women with suspected androgen excess, an OV of >10 mL in at least 1 ovary is not associated with metabolic syndrome but is associated with younger age; an increased body mass index and waist circumference; a higher prevalence of hirsutism, oligoovulation, and polycystic ovary syndrome; and a higher 60-minute insulin level during the oGTT. Overall, an increased OV appears to be a good marker for hyperinsulinemia and hyperandrogenism in women suspected of having an androgen excess disorder.

Polycystic ovary syndrome (PCOS) is a common endocrinopathy among women of reproductive age associated with hyperandrogenism, oligo-amenorrhea, and infertility. Symptoms and their severity vary among the individuals. If the manifestation is mild, PCOS may remain undiagnosed. In more severe cases, it results in a spectrum of symptoms of metabolic syndrome, insulin resistance, and cardiovascular diseases. The diagnosis is established after a physical examination and evaluating the patient’s hormonal profile. In addition to these required methods, ultrasonographic assessment of the patient’s ovaries is another non-invasive, cheap, and time-saving tool, making the examination more profound and leading to the correct diagnosis. Specific ultrasonographic parameters are used to tell the healthy and polycystic ovaries apart: the ovarian volume (OV), ovarian follicle count, follicle distribution pattern, ovarian stromal echogenicity, and the resistance and pulsatility indices assessed using the Doppler function. This review evaluated the selected articles and ascertained the ultrasonographic parameters that accurately predict PCOS. This systematic review showed that the most valuable ultrasonographic parameters in diagnosing PCOS are the OV and follicle number per ovary.

Objective: In this study, patients were divided into two groups. Patients with polycystic ovary syndrome (PCOS) and patients with polycystic ovary syndrome + Hashimoto's Thyroid (PCOS + HT). The effect of insulin resistance on ovarian volume in patients divided into two groups and the change in ovarian volume with the addition of HT to PCOS will be investigated. Material and methods: 46 PCOS patients and 46 PCOS patients diagnosed with HT were included in this study. A detailed medical history was taken from all participants. Polycystic ovary image was evaluated as below or above 10 ml and antral follicles were counted by transvaginal ultrasound. Insulin resistance of the patients was evaluated according to the fasting insulin (HOMA) index. Results: Insulin resistance was found to be associated with fasting insulin, HOMA index, body mass index and right ovarian volume in patients diagnosed with PCOS. Among the patients diagnosed with PCOS + HT, insulin resistance was found to be significantly correlated with fasting insulin, HOMA index, (BMI), (SHBG) and left ovarian volume. An increase in right ovarian volume was found in 37.5% of patients with PCOS without insulin resistance and in 76.3% of patients with insulin resistance. An increase in left ovarian volume was found in 35.7% of patients without insulin resistance diagnosed with PCOS + HT and in 68.8% of patients with insulin resistance. Conclusions: This study shows that ovarian volume should be evaluated in every PCOS patient in order to predict insulin resistance, which causes long-term metabolic diseases, and that all PCOS patients with increased ovarian volume should be investigated for insulin resistance. In addition, it has been observed that insulin resistance affects left ovarian volume in patients with PCOS + HT, whereas insulin resistance affects the volume of the right ovary more in patients with PCOS. At least one ovary has been found to be affected by long-term metabolic diseases. While there was a greater increase in ovarian volume with the addition of insulin resistance, no significant change was observed in the number of patients with increased ovarian volume (PCOS-58, PCOS + HT-57) with the addition of HT finding. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Enlargement and cystic changes in ovaries of patients with long-standing overt hypothyroidism have been described in numerous case reports. However, there are limited data about the effect of subclinical hypothyroidism (SH) on ovarian volume. The aim of the study is to evaluate the relationship between serum thyroid stimulating hormone (TSH) level and ovarian volume in prepubertal girls with SH. METHODS: Patients who were aged between 6 and 10 years and diagnosed with SH and age-matched healthy euthyroid controls were enrolled in the study. All subjects were prepubertal. RESULTS: Thirty-five children with SH (mean age; 7.6±1.0 years) and 50 euthyroid healthy girls (mean age; 7.7±1.2 years) were enrolled in the study. TSH and LH levels and both ovarian volumes were significantly higher in SH group than controls (p<0.05). In addition, TSH was positively correlated with ovarian volumes and LH in patients with SH (p<0.05). CONCLUSION: The results of this study showed that ovarian volumes of prepubertal girls with SH were significantly greater than those with normal thyroid function. Although ovarian enlargement and cyst formation is well recognized in long-standing overt hypothyroidism, it has been shown for the 1st time in patients with SH. [ABSTRACT FROM AUTHOR]

Background/objectives: Women are ubiquitously exposed to endocrine disruptors, including phthalates. Ovarian follicles undergoing folliculogenesis (indirectly measured by ovarian volume) produce anti-Müllerian hormone (AMH) and estradiol (E2). We evaluated associations of phthalates with ovarian volume to assess whether this explained prior positive associations of phthalates with AMH and E2. Methods: Women ages 45–54 years (n = 614) had transvaginal ultrasounds of right/left ovaries to calculate mean ovarian volume. Women provided up-to-four urine and blood samples for quantifying AMH (first serum sample), E2 (all serum samples), and nine phthalate metabolites (from pooled urine, representing six parent phthalates). Multivariable linear or logistic regression models (for individual phthalate biomarkers), as well as weighted quantile sum (WQS) regression (for mixture analyses) evaluated associations of phthalate biomarkers with ovarian volume. Using cross-sectional mediation analysis, we assessed whether associations of phthalates with ovarian volume partially explained those of phthalates with AMH or E2. Results: Most women were non-Hispanic White (68%) and pre-menopausal (67%) with higher urinary phthalate metabolite concentrations than U.S. women. In single-pollutant models, 10% increases in mono(3-carboxypropyl) phthalate (MCPP) and monobenzyl phthalate (MBzP) were associated with 0.44% (95% CI: −0.02%, 0.91%) and 0.62% (95% CI: 0.02%, 1.23%) larger ovarian volumes, respectively. As a cumulative mixture, 10% increases in the phthalate mixture were associated with 2.89% larger ovarian volume (95%CI: 0.27, 5.59) with MCPP (35%) and MBzP (41%) identified as major contributors. Higher ovarian volume due to a 10% increase in MBzP (indirect effect OR: 1.004; 95% CI: 1.00, 1.01) explained 16% of the positive association between MBzP and higher AMH, whereas higher ovarian volume due to a 10% increase in MCPP (indirect effect %Δ: 0.11; 95% CI: −0.01, 0.22) explained 23% of the positive association between MCPP and E2. Conclusion: In this cross-sectional study, phthalates were associated with increased ovarian volume, with implications for midlife hormone production.

Background: Polycystic ovary syndrome (PCOS) is diagnosed based on chronic anovulation, androgen excess (clinical and/or biochemical), and polycystic ovaries in ultrasound. The aim of the present study was to evaluate which parameters in the transvaginal ultrasound (TVUS) of ovaries could be better associated with concurrent hormonal imbalance in the women with PCOS. Methods: Using a cross-sectional design, this study focused on 61 subjects (18–40 years) with PCOS. Patients were recruited at three academic hospitals during the 2017–2019 period. PCOS was defined according to the Rotterdam criteria. The association of ovarian morphology with hormonal and metabolic feature was investigated using linear regression models, adjusted for a set of possible confounding variables including age, mensuration status and body mass index (BMI). Results: The mean volume of both ovaries was positively associated with the total testosterone level (β = 0.025, P value < 0.001), free androgen index (β = 0.041, P value < 0.001) and luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio (β = 0.032, P value = 0.004), even after adjustments made for age, mensuration status and BMI (fully-adjusted model). In contrast, in the fully-adjusted model, antral follicle count (AFC), follicle number per ovary (FNPO), ovarian area, stromal area, and ratio of stromal area to ovarian area (S/A) were not associated with androgen levels and LH/FSH ratio. In addition, after full adjustments, ovarian volume, AFC, FNPO, ovarian area, stromal area and S/A were not associated with insulin resistance, which was estimated by the homeostasis model assessment of insulin resistance (HOMA-IR). Conclusion: Increased ovarian volume is, thus, highly predictive of hyperandrogenemia and high LH/FSH ratio in PCOS patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of Zhibai Dihuang Pill on the ovarian volume, follicular diameter and secondary sexual characteristics of ICPP girls. Results: From February 2019 to February 2021, 86 girls with ICPP treated in our hospital were ran- domly divided into control group (n=43) and observation group (n=43). The control group was given tripriline acetate, and the observa- tion group was given Zhibaidihuang pill in addition to the control group. Compare two groups clinical curative effect, the volume of uterus, ovarian volume and follicle diameter, sex hormone levels [follicle stimulating hormone (FSH), estradiol (E2) and luteinizing hor- mone (LH)], bone metabolism index level [ I type collagen amino peptide (P1NP), osteocalcin in the n-terminal molecular fragment (N-MID), collagen type I carboxyl end peptide crosslinking (beta CTX)] Adverse reactions. Results: After treatment, compared with the control group, the total effective rate of observation group was significantly higher (P<0.05), the uterine volume, ovarian volume and fol- licular diameter were significantly smaller (P<0.05), the levels of FSH, E 2, LH, P1NP, N-mid and β -CTX were significantly lower (P<0.05). There was no difference in the total incidence of adverse reactions between the two groups ( P>0.05). Conclusions: Zhibaidihuang pill has good clinical efficacy in the treatment of children with ICPP. It can reduce the advance changes of ovary and uterus, reduce the level of sex hormone, improve the level of bone metabolism index, and has good safety. [ABSTRACT FROM AUTHOR]

Nguyen Sa Viet Le,1,2 Minh Tam Le,2,3 Nguyen Dac Nguyen,2,3 Nhu Quynh Thi Tran,3 Quoc Huy Vu Nguyen,2 Thanh Ngoc Cao2,3 1Department of Assisted Reproduction, Hue Central Hospital, Hue, Vietnam; 2Department of Obstetrics and Gynecology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam; 3Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue, VietnamCorrespondence: Minh Tam Le Email leminhtam@huemed-univ.edu.vnPurpose: 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.Keywords: ovarian volume, anti-Mullerian hormone, PCOS phenotypes, diagnose, infertility

Objectives: To investigate if the amount of peritoneal fluid (PF) in the Pouch of Douglas at oocyte pick-up (OPU) or OPU + 5 days predict severe late-onset ovarian hyperstimulation syndrome (OHSS) in women undergoing ovarian stimulation for assisted reproductive technology (ART).Study Design: A secondary analysis of a dual-centre RCT on 1050 women referred for their first ART treatment in two public fertility clinics in Denmark and randomized 1:1 to GnRH-antagonist or GnRH-agonist protocol. All women from the two arms who were examined on day of OPU and OPU + 5 days were included in this study (n = 940). The ability of PF in the pouch of Douglas to predict severe late-onset OHSS was assessed by multivariate logistic regression analyses and receiver operator characteristics (ROC) curve analyses and compared with other known predictors of OHSS. The final models were cross-validated by the leave-one-out method to assess the models' generalizability.Results: A total of 28 (3%) women developed severe late-onset OHSS. PF in the pouch of Douglas measured on OPU + 5 days predicted severe late-onset OHSS. The optimal cut-off value was 17.5 mm at OPU + 5 days with a 61% sensitivity and 71% specificity (Area under the curve = 0.70 95% CI 0.61-0.80). PF on the day of OPU was not predictive of late on-set OHSS as the adjusted multivariate logistic regression analyses showed insignificant results.Conclusion: Although PF in the pouch of Douglas could predict late-onset severe OHSS, the low sensitivity underlines that it is not useful as a sole marker to decide whether to perform blastocyst transfer or to use a freeze-all strategy. [ABSTRACT FROM AUTHOR]

Dodi Suardi, Wiryawan Permadi, Tono Djuwantono, Yudi Mulyana Hidayat, Hartanto Bayuaji, Gusti Putu Edo Gautama Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, IndonesiaCorrespondence: Gusti Putu Edo GautamaFaculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Jl. Pasteur No. 38, Bandung, 40161 Jawa Barat, IndonesiaTel +6222 203 2530Fax +6222 203 9086Email edogautama@yahoo.comBackground: 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.Keywords: anti-Mullerian hormone, AMH, endometrioma, ovarian volume

Abstract Background Premature ovarian failure (POF) is characterized by the loss of ovarian activity before the age of 40 years. Stem cell therapy has the capability to create a regenerative microenvironment and is a proposed treatment for POF-related infertility due to the presence of renewal folliculogenesis and germ cells in the adult ovaries. In this study, we assessed the safety, feasibility, efficacy and dose adjustment of autologous adipose-derived stromal cells (ADSCs) and their ability to improve ovarian function in POF patients. Methods This study was a non-randomized clinical trial, phase I. Nine women with a definitive diagnosis of POF were divided into three groups (n = 3 per group) that received either 5 × 106, 10 × 106, or 15 × 106 autologous ADSCs suspension transplanted in the one ovary. Participants were followed-up at 24 h after the transplantation, and at 1 and 2 weeks, and 1, 2, 3, 6, and 12 months after the transplantation. The primary objective was to evaluate the safety of ADSCs transplantation. Secondary objectives included the effects of ADSCs transplantation on the resumption of menstruation, hormones level (Follicle-stimulating hormone (FSH) and anti-Müllerian hormone), ovarian function (Antral follicle count and ovary volume by ultrasonography evaluation) as well as dose escalation. Results Participants had not shown any early-onset possible side effects and secondary complications during follow-up. The menstruation resumption was observed in four patients which established for several months. In the 15 × 106 group, two POF patients had a return of menstruation second months after the intervention. Two other POF patients in 5 × 106 and 10 × 106 cell groups reported menstruation resumption at 1 month after the intervention. We observed decreased serum FSH levels of less than 25 IU/l in four patients. In two patients in 5 × 106 and 10 × 106 cell groups, serum FSH showed an inconsistent decline during a 1 year follow up after ADSCs transplantation. The ovarian volume, AMH, and AFC were variable during the follow-up and no significant differences between cell groups (p > 0.05). Conclusions We showed the intra-ovarian embedding of ADSCs is safe and feasible and is associated with an inconsistent decline in serum FSH. This should be further investigated with a large RCT. Trial registration NCT02603744 , Registered 13 November 2015 - Retrospectively registered, http://www.Clinicaltrials.gov

Purpose: The aim of this study was to determine the relationship between polycystic ovarian morphology (PCOM), ovarian morphology, anti-Müllerian hormone (AMH), and testosterone levels in young nulliparous Korean women. Materials and Methods: A total of 139 PCOM patients were evaluated from 2013 to 2018. The relationships between serum AMH levels and androgenic hormones, clinical signs of polycystic ovarian syndrome (PCOS), and ovarian morphology were investigated. Results: Irregular menstruation was the most common symptom in women with PCOM. This study found that hyperandrogenism was present in 26.6% of nulliparous Korean women with PCOM. The present findings support the use of serum AMH as a useful marker to reflect PCOM in cases where accurate ultrasounds are not available. Conclusions: This study found that PCOM did not equate with PCOS, although PCOM is one of the diagnostic criteria for PCOS. AMH levels were positively correlated with ovarian volume and AMH levels were not reflected by hyperandrogenism. Content: The use of serum AMH as a useful marker to reflect PCOM in cases where accurate ultrasounds are not available.

Ovarian torsion is a surgical emergency, as it could lead to tissue necrosis and loss of fertility in the long term when diagnosis and intervention are delayed. In this study, the effectiveness of sonographic ovarian appearance in the decision of surgery and the clinical value of ovarian size in the diagnosis of torsion were investigated in premenarchal girls whose diagnosis of ovarian torsion was surgically verified. A retrospective cohort study design was utilized. Demographic characteristics, physical examination find ings, laboratory findings, ultrasonography findings, operation records, pathology reports of 20 premenarchal girls who were admitted to Van Yuzuncu Yil University Medical Faculty Emergency Service between 2010-2020 and who were surgically confirmed to have torsion scanned and recorded. The cases included in the study were divided into two groups: nine patients with normal ovarian torsion (group1) and eleven patients with mass or cystic ovarian torsion (group2). Regarding the duration passed between admissio n to the emergency department and undergoing surgery, the time was shorter in group 2 compared to group 1 (13.54 ± 6.02 hours and 77.0 ± 101.86 hours respectively; p=0.053). Conservative surgical treatment was realized in all patients in Group 1 (9/9; 100%) and 7 patients in Group 2 (7/11; 63.6%); patients in Group 2 underwent cystectomy. Furthermore, oophorectomy was performed on 4 patients in Group 2. In terms of the torsion side, right-sided torsion predominance was detected in the ovary in both groups (6 patients (66.6%) in Group 1 and 7 patients (63.6%) in Group 2. Ovarian volume and Doppler flow could be considered as a potential predictive variable for ovarian torsion. [ABSTRACT FROM AUTHOR]

The present study aims to assess the usefulness of severity markers in women with ovarian hyperstimulation syndrome (OHSS). An observational study was designed including 76 women with varying degrees of severity of OHSS. Clinical history, physical examination, laboratory tests, and ultrasound measurement of the ovarian size and ascites index were carried out in all patients. Intra-abdominal pressure (IAP) was measured using an intravesical Foley Manometer catheter. Ascites index and ovarian volume increased progressively being highest in the most severe stage of OHSS. The median IAP in mild OHSS was found to be lower than that in the moderate and severe OHSS (4.0 mm, 12 mm, and 16.0 mm, respectively). Critical cases of OHSS presented the highest IAP (25.0 mm). IAP did not reach the level of intra-abdominal hypertension in mild OHSS, whereas moderate and severe OHSS was associated with intra-abdominal hypertension grade I and grade II–III, respectively. Values of IAP in critical OHSS were found similar to those observed in abdominal compartment syndrome patients. The IAP showed a strong positive correlation with ovarian volume and ascites index. The reduction of IAP after paracentesis was greater among critical OHSS patients. The ovarian volume and the level of intra-abdominal hypertension are related to the severity of OHSS and are of particular importance in the initialization of the syndrome. Ascites index is simple and convenient and can serve as an indirect marker of the abdominal reserve volume. In conjunction with clinical and laboratory data, ascites index and IAP values might be indicators for paracentesis. [ABSTRACT FROM AUTHOR]

Background: Infertility is a social problem and a big stigma. The objectives of the study were to determine the age wise distribution of ovarian volume and the difference in ovarian volume between married fertile and infertile women with transvaginal sonography. Materials & Methods: This comparative, cross-sectional study was conducted in the Department of Anatomy, Gomal Medical College, D.I.Khan, Pakistan from March 2013 to December 2013. Sample Size was 100 women selected by consecutive non probability sampling technique. Sample size was calculated using online calculator Raosoft. Inclusion criteria were women aged 18-50 years, married, fertile and infertile. Color Doppler sonoscape with multi frequency transvaginal probes were used in measurements on any day in the start of menstrual cycle by the same observer. The volume was calculated by applying formula for ellipsoid called Prolate ellipsoid formula. The total volume was represented by sum of volume of two ovaries. Data collection site was out patient department of Radiology DHQ Teaching Hospital, D.I.Khan. Demographic variable were age groups and presence of fertility. Research variable was ovarian volume. Mean and standard deviation were calculated for ovarian volume whereas frequency and percentages were calculated for age groups and presence of fertility. Descriptive statistics along with estimation of parameter was done at 95% confidence interval for proportion and mean. Student- t test was used for significance of difference in ovarian volume between fertile and infertile women with p value

Objective. 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

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. [ABSTRACT FROM AUTHOR]

Background: Premature ovarian failure (POF) is characterized by the loss of ovarian activity before the age of 40 years. Stem cell therapy has the capability to create a regenerative microenvironment and is a proposed treatment for POF-related infertility due to the presence of renewal folliculogenesis and germ cells in the adult ovaries. In this study, we assessed the safety, feasibility, efficacy and dose adjustment of autologous adipose-derived stromal cells (ADSCs) and their ability to improve ovarian function in POF patients. Methods: This study was a non-randomized clinical trial, phase I. Nine women with a definitive diagnosis of POF were divided into three groups (n = 3 per group) that received either 5 × 106, 10 × 106, or 15 × 106 autologous ADSCs suspension transplanted in the one ovary. Participants were followed-up at 24 h after the transplantation, and at 1 and 2 weeks, and 1, 2, 3, 6, and 12 months after the transplantation. The primary objective was to evaluate the safety of ADSCs transplantation. Secondary objectives included the effects of ADSCs transplantation on the resumption of menstruation, hormones level (Follicle-stimulating hormone (FSH) and anti-Müllerian hormone), ovarian function (Antral follicle count and ovary volume by ultrasonography evaluation) as well as dose escalation. Results: Participants had not shown any early-onset possible side effects and secondary complications during follow-up. The menstruation resumption was observed in four patients which established for several months. In the 15 × 106 group, two POF patients had a return of menstruation second months after the intervention. Two other POF patients in 5 × 106 and 10 × 106 cell groups reported menstruation resumption at 1 month after the intervention. We observed decreased serum FSH levels of less than 25 IU/l in four patients. In two patients in 5 × 106 and 10 × 106 cell groups, serum FSH showed an inconsistent decline during a 1 year follow up after ADSCs transplantation. The ovarian volume, AMH, and AFC were variable during the follow-up and no significant differences between cell groups (p > 0.05). Conclusions: We showed the intra-ovarian embedding of ADSCs is safe and feasible and is associated with an inconsistent decline in serum FSH. This should be further investigated with a large RCT. Trial registration: NCT02603744, Registered 13 November 2015 - Retrospectively registered, http://www.Clinicaltrials.gov [ABSTRACT FROM AUTHOR]

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 newonset 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. [ABSTRACT FROM AUTHOR]

Limited data exist on the morphologic and physiologic effect on the remaining ovary after unilateral oophorectomy, especially in the pediatric population. Our aim is to evaluate ovarian volumes following unilateral oophorectomy to determine whether compensatory ovarian hypertrophy occurs in the remaining contralateral ovary. This was a retrospective chart review of ovarian volume measured on ultrasounds that were completed after unilateral oophorectomy. Postoperative ovarian volumes were compared to established radiologic standards. Large tertiary care academic children's hospital in Atlanta, GA. Female patients less than 21 years old who underwent unilateral oophorectomy. Ovarian volumes measured on postoperative ultrasounds. A total of 93 patients met inclusion criteria for this study. Serial ultrasounds were performed in slightly more than half of the patients (n = 48, 51.6%), totaling 193 postoperative ovarian volumes. The average age of oophorectomy was 10.8 years. Prior to surgery, the majority of patients presented with abdominal pain (n = 51, 54.8%) or pelvic mass (n = 51, 54.8%), and most (n = 77, 82.8%) had benign final pathology. Ovarian volumes were compared to 4 published radiologic ultrasound standards. More than 62.2% of ovarian volumes from girls who had previously had unilateral oophorectomy were larger than age-matched standard ovarian volumes. Ovarian enlargement occurs in the contralateral ovary following unilateral oophorectomy in the pediatric and adolescent population. This supports the concept of compensatory ovarian hypertrophy. This knowledge provides valuable information for interpretation of radiologic images in young female individuals who have undergone oophorectomy, and can assist with counseling on the risk of adnexal complications due to ovarian hypertrophy after unilateral oophorectomy. [ABSTRACT FROM AUTHOR]

Both 2-D and 3-D transvaginal ultrasonography are effective imaging modalities for assessment of ovarian reserve. Our aim was to compare both modalities in assessment of ovarian reserve of women undergoing in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI). Fifty women were scheduled according to their menstrual cycle to be examined by both 2-D and 3-D transvaginal ultrasonography. We found that the average time for computerized analysis of the 3-D ultrasound data was significantly shorter than that for analysis of the 2-D ultrasound data, for both total antral follicle count and ovarian volume. However, there were no statistically significant differences between the methods in total antral follicle count and ovarian volume. We conclude that, where available, 3-D ultrasonography can be used for assessment of ovarian reserve in addition to the biochemical marker, particularly in overcrowded in vitro fertilization centers that need to save time. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to analyze the correlation of ovarian volume and clinical and laboratory parameters of polycystic ovary syndrome (PCOS) in Korean women. Methods: Two hundred and thirty-three patients aged between 20 and 40 years with PCOS diagnosis between January 2014 and June 2020 at Pusan National University Hospital, Busan, Republic of Korea, were included to this retrospective observational study using previously recorded patient medical charts. PCOS was diagnosed according to the revised 2003 Rotterdam criteria. Laboratory tests including anti-mullerian hormone (AMH), prolactin, thyroid stimulating hormone (TSH), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, free and total testosterone, dehydroepiandrosterone-sulfate (DHEA-S), 17-alpha-hydroxyprogesterone (17-OHP), HbA1C and insulin were conducted. Results: The correlation analysis showed that free testosterone (p = 0.006, r = 0.215), total testosterone (p < 0.001, r = 0.305), 17-OHP (p = 0.008, r = 0.203) and height (p = 0.008, r = 0.173) were statistically correlated with the total ovarian volume in overall PCOS patients. In these patients, serum AMH level was positively correlated with LH but negatively with body weight and body mass index (BMI). Conclusions: According to the results, the ovarian volume, quantified by ultrasonographic measurements, was significantly related to the increasing serum levels of free testosterone, total testosterone and 17-OHP in Korean PCOS patients.

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. [ABSTRACT FROM AUTHOR]

Background: Knowledge of ovarian volume is important for diagnostic evaluations; however, normal ovarian volume studies on children and adolescents are lacking.Objective: This study aimed to analyze age-specific ovarian volume and identify the diverse factors that contribute to ovarian diagnoses.Materials and Methods: We retrospectively enrolled 180 patients (0-18 years of age) with normal ovaries who underwent magnetic resonance imaging (MRI) between 2010 and 2018. MRI sequences included coronal and axial T2-weighted turbo spin echo (TSE) images and coronal T1-weighted TSE images. Ovarian volume was calculated by the standard ellipsoid formula. Age-specific ovarian volume, height, weight, height-adjusted total ovarian volume and body mass index were obtained. Linear regression analysis was used to predict ovarian volume.Results: Six age groups (infant; early and late child, and early, middle and late adolescent) were described. The early adolescent group (10-12 years) had the highest rate of increase. In the middle adolescent period (13-15 years), the curve of ovarian volume appeared flat.Conclusion: Our findings provide age-specific references for ovarian volume. [ABSTRACT FROM AUTHOR]

Study Objective: Because laparoscopic ovarian cystectomy of endometriomas is known to adversely impact patient ovarian reserve, the search for other techniques of surgical management is ongoing. The present study was undertaken to evaluate laparoscopic cyst deroofing as a feasible alternative.Study Design: Prospective, randomized clinical trial (Canadian Task Force classification I).Setting: University maternity hospital.Patients: Women diagnosed with unilateral or bilateral ovarian endometriomas.Interventions: Patients were managed with either laparoscopic ovarian cystectomy or cyst deroofing.Measurements and Main Results: A total of 122 women with endometriomas were randomized to either laparoscopic cystectomy (group 1) or laparoscopic cyst deroofing (group 2). The primary endpoint was the effect on ovarian reserve based on changes in anti-Müllerian hormone (AMH) values. At 1 month postsurgery, anti-Müllerian hormone values were significantly decreased (p < .001) from preoperative values, from 4.25 ± 0.87 ng/mL to 1.66 ± 1.02 ng/mL in group 1 and from 4.2 ± 1.69 ng/mL to 2.15 ± 1.48 ng/mL in group 2. In addition, antral follicle count and ovarian volume decreased significantly (p < .001) in both groups by 1 month postsurgery. The decreases in these 3 parameters were more significant (p < .001) in group 1 than in group 2.Conclusion: Laparoscopic cyst deroofing of endometriomas appears to be a promising alternative to laparoscopic cystectomy, with less postoperative decrease in ovarian reserve; however, the higher rate of endometrioma recurrence warrants future clinical research to determine the optimal surgical management of endometriomas. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the findings of ultrasound that could predict the metabolic syndrome (MetS) which may develop in polycystic ovary syndrome (PCOS) patients. A total of 96 consecutive PCOS patients, who were scheduled for any gynaecologic examination from January 2015 to January 2016 and who were eligible for the study, were prospectively enrolled in it. About 15.6% of PCOS patients were diagnosed with MetS. The mean age of the MetS patients and the non-MetS patients were 25.8 and 23.3, respectively (p = .056). The mean ovary volume was calculated as being 11.7 mL in the MetS patients and as 9.6 mL in the non-MetS patients (p = .027). The Doppler and the other ultrasound findings were compared between the groups and no significant difference was observed. When a receiver operator characteristic curve analysis was conducted for the ovarian volume to predict MetS, the area under curve was 0.67 (95% CI, 0.52-0.81). The optimum cut-off point for OV was determined at 9.2 mL, with the sensitivity and specificity of 80.0% and 50.6%, respectively. The risk of developing MetS appears to be higher in PCOS patients with higher OV values. Impact statement What is already known on this subject? Metabolic syndrome is not rare in PCOS patients. There are several studies to specify a predictor for MetS development in PCOS. Most are biochemical predictors, such as hyperandrogenemia, a visceral adiposity index, lipid accumulation product, adiponectin index and a leptin-to-adiponectin ratio. What do the results of this study add? The ultrasound markers to predict the insulin resistance at PCOS is already used, but are new for predicting MetS. What are the implications of these findings for clinical practice and/or further research? Ultrasound is an available tool in most clinics and predicting MetS is important for the future health problems of PCOS patients. [ABSTRACT FROM AUTHOR]

Background: Ovarian reserve tests have appeared as important, useful and new tools in evaluation of infertile women and by doing these tests, we can do for infertile couples advanced and necessary measures quickly. The goal of this study was to investigate the association between ovarian volume, Antral follicle counts and serum level of FSH at the third day of menstruation. Material and Methods: This study was conducted on 78 women between 18-49 years old who referred to Omid Persian gulf infertility Clinic with complaining of infertility in 2014. In patients who had inclusion criteria, measurement of ovarian volume were done with calculation of three diameters and the number of antral follicles by using vaginal ultrasound in third day of menstruation. Also, in this patients were measured the levels of FSH&LH in third day of menstruation. Pearson correlation coefficient were used to examine the relationship between ovarian volume and the number of Antral follicles and serum levels. Results: ovarian volume and Antral follicle counts (p=0.0001) decreased and serum level of FSH (p=0.0001) and LH (p=0,022) increased significantly with increasing of age. There was a strong positive correlation between ovarian volume and Antral follicle counts (r=0.96, p=0.0001) and there was a strong reversed correlation between ovarian volume and Antral follicle counts with FSH (r=0.50, p=0.0001). Conclusion: By increasing age, ovarian volume and Antral follicle counts decreased and FSH&LH levels increased. In fact, in the initial study of infertile patients, even by diagnosis of reduction in ovarian volume and Antral follicle count should be performed advanced therapies and there is no need to wait for expensive tests result.

Background: Ovarian reserve tests in unexplained infertility patients before management either by ovulation induction or IVF program are a worthy procedure as it saves unnecessary procedures, induction complications, canceled cycles, wasted resources and emotional stress to the couple in case of low estimate, and can as well help in adjusting the doses to obtain the most appropriate response. Aim of work: To determine the value of mean ovarian volume, AFC, maternal age, FSH and AMH in infertile patients undergoing ovulation induction or IVF cycles. Primary outcome is to predict the best parameter of ovarian reserve. Design: Prospective cross-sectional study. Patients and methods: One hundred infertile women received treatment in the form of induction of ovulation and timed intercourse/IUI or IVF. They had basal FSH, AMH, AFC and mean ovarian volume assessment. The response was then evaluated according to the number of follicles on the day of hCG or the number of oocytes retrieved in IVF cycles. Results and conclusion: The total AFC and AMH are found to correlate significantly with the ovarian response with p values

The aims of this study were to identify ultrasound-based predictors of ovarian torsion in girls without an adnexal mass and establish a set of normal values for ovarian volume ratio (OVR). A retrospective review was performed of all premenarchal patients ≥ 3 years of age with a normal pelvic ultrasound between January 2016 and January 2019. A comparison group of premenarchal girls presenting between 2011 and 2019 with torsion in the absence of an adnexal mass was utilized. Five-hundred and four premenarchal girls underwent pelvic ultrasound evaluation with a normal examination. The mean OVR was 1.6 ± 0.7 (range 1.0–6.5). OVR did not vary with age (r = − 0.06) as compared to ovarian width which increased steadily with age (r = 0.53, p < 0.001). OVR was increased in girls with torsion (7.6 vs 1.4, p < 0.0001), and by receiver operating characteristic (ROC) analysis a cutoff value of > 2.5 demonstrated the best diagnostic accuracy of any predictive variable (sensitivity 100%, specificity 94%, AUC 0.991, p < 0.001). OVR is an excellent predictor of ovarian torsion in premenarchal girls without an adnexal mass. Unlike ovarian width, OVR does not increase with age, and a cutoff OVR > 2.5 demonstrates high sensitivity and specificity for identifying ovarian torsion in this population. Study of diagnostic test. Level III. [ABSTRACT FROM AUTHOR]