Hypoplasia of ovaries
- Reasons of a hypoplasia of ovaries
- Symptoms of a hypoplasia of ovaries
- Treatment of a hypoplasia of ovaries
Hypoplasia of ovaries – an anatomic and functional underdevelopment of female gonads – ovaries. At a hypoplasia of ovaries the hypomenstrual molimina or an amenorrhea, decrease a libido, infertility is noted. The hypoplasia of ovaries is diagnosed by the general and gynecologic survey, results of ultrasonography of bodies of a small pelvis, hormonal researches, a laparoscopic biopsy of ovaries, definition of a karyotype (chromosomal complement). Treatment of a hypoplasia of ovaries demands performing cyclic hormonal therapy.
Reasons of a hypoplasia of ovaries:
The hypoplasia of ovaries is more often noted against the background of the general or sexual infantility; it can be combined with a uterus hypoplasia, an aplasia of a uterus and vagina (Rokitansky-Kyustnera's syndrome), a hypoplasia of kidneys, an underdevelopment of other bodies. Besides, the hypoplasia of ovaries meets at a dysgenesis of gonads – the genetic diseases caused by qualitative and (or) quantitative pathology of gonosomes (Shereshevsky's syndrome – Turner, etc.). In these cases the parenchyma of ovaries is presented preferential or exclusively connecting fabric.
The acquired hypoplasia of ovaries is a consequence of adverse effects on an organism during ontogenesis, especially at children's age or during the pubertal period. Development of a hypoplasia of ovaries can be promoted by inflammations of gonads (oophorites, adnexites), abortion, disturbances of food (hypovitaminosis, anorexia), chronic intoxications, children's infections (parotitis, a rubella, measles, scarlet fever, etc.), quinsies, to an endocrinopathy (inflammatory damages of a hypophysis and a hypothalamus, adenoma of a hypophysis, a prolaktinom, a hypothyroidism, etc.), radiation by radioactive materials.
More rare the hypoplasia of ovaries happens is caused by pre-natal defeat of the follicular device owing to pregnancy pathology at mother.
According to an etiology and level of defeat the gynecology allocates a hypoplasia of ovaries of the central (gipotalamo-pituitary) genesis; peripheral (ovarian) genesis and idiopathic (not clear) origin.
At a hypoplasia in ovaries reduction of expressiveness of a follicular layer is noted. In hypoplastic ovaries of primitive egg cells and primordialny follicles can not be absolutely or be noted the termination of their maturing and growth that defines a picture of clinical manifestations.
Symptoms of a hypoplasia of ovaries:
At patients with a hypoplasia of ovaries various disorders of menstrual function – primary, sometimes a secondary amenorrhea, альгодисменорея or a hypomenstrual molimina, an anovulatory cycle can be observed. The listed disturbances at a hypoplasia of ovaries are followed by infertility.
Patients are put on female type, but have slightly expressed eunuchoid signs. At a hypoplasia of ovaries secondary sexual characteristics are usually expressed poorly – scanty pilosis on a pubis and in axillary hollows, flattening of mammary glands, not expressiveness of an areola and nipples is noted. Lack of the first periods (menarche) by 15-16 years is characteristic.
Sexual desire at women is lowered, frigidity is quite often observed. Other signs of a hypoplasia of ovaries come to light when carrying out comprehensive gynecologic examination.
At gynecologic survey the hypoplastic structure of outside genitalias, the tonyoky not pigmented small vulvar lips, existence of a narrow inextensible and short vagina, infantilism of a uterus pays attention.
When performing ultrasonography, OUSE-gisterosalpingoskopii or and gisterosalpingografiya is confirmed reduction of the sizes of ovaries and a uterus, the twisting, thin, extended uterine tubes are defined.
Basal temperature has monophase character. The research of cervical slime at a hypoplasia of ovaries allows to reveal gipoestrogeniya signs – the negative or poorly expressed symptom of "pupil". Low level of estrogen (in certain cases - gonadotropic hormones) is confirmed at a laboratory blood analysis.
Conducting test with progesterone at a hypoplasia of ovaries usually yields a negative take, testifying to the expressed oestrogenic insufficiency. The test combined estrogen-gestagennaya positive that testifies to functional safety of an endometria.
For identification of the central form of a hypoplasia of ovaries resort to conducting tests with a menopauzny human gonadotrophin, a chorionic gonadotrophin, clomifene, lyuliberiny; to performance of a X-ray analysis of the Turkish saddle, brain MRT.
If necessary the diagnostic laparoscopy and a biopsy of ovaries is carried out.
Treatment of a hypoplasia of ovaries:
At a hypoplasia of ovaries treatment pursues the aims of recovery of hormonal and reproductive functions. A therapy basis at a hypoplasia of ovaries is cyclic hormonal therapy.
At the first stage hormonal therapy is directed to creation of an estrogenic background, and after emergence of menstrualnopodobny reaction - to normalization cyclic гипоталамо-гипофизарно-яичниково-маточных processes. Hormonal therapy is carried out under control of a follikulometriya.
At the same time at a hypoplasia of ovaries vitamin therapy, physical therapy (magnetotherapy, magnetolaser therapy, laser therapy, ультрафонофорез, etc.), gynecologic massage, balneoprotsedura are appointed.
Under the influence of hormonal therapy characteristic female sexual characters develop. At induction of a two-phase menstrual cycle at patients with a hypoplasia of ovaries chances of pregnancy make from 30 to 60%; at the same time the probability of development of polycarpous pregnancy is not excluded. Course and conducting pregnancy at patients with a hypoplasia of ovaries is accompanied by risks of not incubation.
Women with a hypoplasia of ovaries have to be observed at the gynecologist-endocrinologist for timely detection of gipotalamo-pituitary tumoral processes and hyperplastic disturbances in the sexual device under the influence of hormonal therapy.