Treatment of autoimunne ovarian damage in adolescent girls.
BACKGROUND
To investigate levels of antiovarian autoantibodies in girls and young women with disturbances of menstrual cycle before and during treatment with hormonal therapy. To explain morphological changes in ovarian structure in these patients.


METHODS
Studied group included 39 patients. 18 patients were treated for primary amenorrhoea, 21 for menstrual cycle disorders. Patients included in the study were repeatedly examined at the beginning of the study and after six months during which they were treated by estrogen and gestagen. In all patients we have tested FSH, LH and FSH/LH ratio, presence of antiovarian antibodies. Results were compared with those obtained in control women. 21 antiovarian antibodies positive patients were indicated for laparoscopic biopsy. Bioptic sample was examined using light and electron microscopy.


RESULTS
Our treatment with hormonal therapy lead to the reduction of ovarian antigens. In 85% of the cases marked decrease of antiovarian autoantibodies levels was observed, while in 28% of the cases the levels were undetectable. From morphological changes of the bioptic sample enhanced atresia of follicules at different developmental stages was frequently observed. It evoked marked reduction of follicular apparatus up to its complete disappearing.


CONCLUSIONS
The results of our study and mapping of the antiovarian antibodies positivity support our hypothesis that the antiovarian antibodies positivity corresponds with the clinical symptoms. Appropriate treatment with hormonal replacement therapy minimizes ovarian destruction, preserves ovarian hormonal functions and saves healthy ovarian tissue necessary for future fertility.
Mlcochová
H
H
Department of Pediatric and Adolescent Gynaecology, 2nd Medical Faculty, Department of Pediatric and Adolescent Gynaecology, 2nd Medical Faculty, Charles University Prague, Czech Republic. hana.mlcochova@seznam.cz
Horejsí
J
J
Martinek
J
J
Vetesníková-Koubová
R
R
Halaska
M
M
D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000032:analysis / Q000187:drug effects / Q000276:immunology*; D004338:Drug Combinations; D004958:Estradiol / Q000627:therapeutic use; D004964:Estriol / Q000627:therapeutic use; D005260:Female; D005854:Germ Cells / Q000276:immunology / Q000473:pathology; D020249:Hormone Replacement Therapy; D006801:Humans; D017258:Medroxyprogesterone Acetate / Q000627:therapeutic use; D008599:Menstruation Disturbances / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D010053:Ovary / Q000276:immunology* / Q000473:pathology; D016649:Primary Ovarian Insufficiency / Q000150:complications / Q000188:drug therapy / Q000276:immunology* / Q000473:pathology; D012016:Reference Values; D015044:Zona Pellucida / Q000276:immunology
D001323:Autoantibodies; D004338:Drug Combinations; C044003:estradiol, estriol drug combination; D004958:Estradiol; D017258:Medroxyprogesterone Acetate; D004964:Estriol