Assessment of ovarian reserve. Is there still a role for ovarian biopsy? First do no harm!
Multiple endocrine, ultrasound-based and dynamic tests have been proposed for the assessment of ovarian reserve. Lately, ovarian biopsy has been proposed as a more representative functional test of ovarian reserve, and has been recommended as an early step in the investigation of infertility. Central to this hypothesis is the idea that a random biopsy of the ovarian cortex is reflective of the actual ovarian follicular pool. Recent studies have shown a wide variation in the number and distribution of ovarian follicles even from the same ovary and in the same patient. Coupled with the invasiveness of performing the biopsy and the risk of adhesion formation, we believe that there should not be a role for ovarian biopsy in ovarian reserve testing.
Sharara
Fady I
FI
Virginia Center for Reproductive Medicine, Reston, USA.
Scott
Richard T
RT
D001706:Biopsy; D005260:Female; D006801:Humans; D006080:Ovarian Follicle / Q000473:pathology*; D010050:Ovarian Function Tests; D010053:Ovary / Q000473:pathology* / Q000503:physiopathology*