Hypoplasia of ovaries

Description:

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.

Diagnosis:

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.

Forecast:

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.