Effectiveness of microlaparoscopy in the diagnosis of premature ovarian failure.
OBJECTIVE
Premature ovarian failure (POF) cases contain a mixture of cases possessing follicles (type A) and those depleted of follicles (type B). Differentiation between the two types is important because the treatment policy and pregnancy prognosis vary greatly. The objective of this study was to examine the usefulness of microlaparoscopy in the differentiation of types A and B.


METHODS
Among 66 patient with POF diagnosed at our department between May 1996 and April 2004, 47 patients who gave informed consent and underwent microlaparoscopy were studied. The cases were divided into four groups based on the laparoscopic ovarian morphology. These groups were analyzed with respect to patient background, blood hormone levels, antinuclear antibody positive rate, visualization of the ovary on transvaginal ultrasonography, presence or absence of follicles in biopsy specimen, and number of follicles.


RESULTS
No significant differences in patient background and serum hormone levels were observed between groups. There was a tendency of increase in antinuclear antibody positive rate, increase in proportion of cases with follicles, and increase in number of follicles as the ovarian morphology approached normal. Transvaginal ultrasonography failed to identify the ovary in all the patients.


CONCLUSIONS
Microlaparoscopy is useful in the differentiation between type A and B POF, and is further expected to become an indicator of response to treatment.
Abe
Noriko
N
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Tokyo, Japan. nori2ka1@yahoo.co.jp
Takeuchi
Hiroyuki
H
Kikuchi
Iwaho
I
Kinoshita
Katsuyuki
K
D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood; D003937:Diagnosis, Differential; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D010535:Laparoscopy; D007986:Luteinizing Hormone / Q000097:blood; D006080:Ovarian Follicle / Q000473:pathology; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology; D016649:Primary Ovarian Insufficiency / Q000175:diagnosis* / Q000601:surgery; D014463:Ultrasonography
D000974:Antibodies, Antinuclear; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone