title: Ovarian primordial and nongrowing follicle counts according to the Stages of Reproductive Aging Workshop (STRAW) staging system.
abstract: OBJECTIVE
  The aim of this study was to characterize the ovarian primordial and nongrowing follicle number according to the Stages of Reproductive Aging Workshop (STRAW) staging system as defined by menstrual cycle characteristics.
  
  
  METHODS
  Normal ovaries were collected from 63 women (age 26-52 y) undergoing oophorectomy for benign indications. Before surgical operation, each participant completed a detailed questionnaire collecting information regarding menstrual cycle characteristics and was classified by bleeding patterns into STRAW stages -4, -3, -2, and -1. A single ovary was selected for the determination of ovarian primordial and total nongrowing follicle number using a validated fractionator/optical disector method. A subset of the participants (n = 43) underwent transvaginal ultrasound examination for the determination of the ovarian antral follicle count and serum measurements of follicle-stimulating hormone, estradiol, antimüllerian hormone, and inhibin B. All measurements were obtained within 2 weeks of surgical operation, irrespective of cycle day.
  
  
  RESULTS
  Significant differences were identified in ovarian primordial (P < 0.0001) and nongrowing follicle (P < 0.0001) counts across the STRAW stages. In post hoc testing, the differences in primordial follicle counts were significant between each of the STRAW stages. Significant differences were also identified in serum levels of antimüllerian hormone, follicle-stimulating hormone, and ovarian antral follicle count across the STRAW stages.
  
  
  CONCLUSIONS
  Progression through the STRAW stages as defined by menstrual cycle characteristics is associated with progressive and significant decreases in the ovarian primordial follicle number.
authors.affiliation: Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73126, USA. karl-hansen@ouhsc.edu
authors.forename: Karl R
authors.initials: KR
authors.lastname: Hansen
authors.forename: LaTasha B
authors.initials: LB
authors.lastname: Craig
authors.forename: Michael T
authors.initials: MT
authors.lastname: Zavy
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Klein
authors.forename: Michael R
authors.initials: MR
authors.lastname: Soules
mesh_terms: D000328:Adult; D000375:Aging / Q000502:physiology*; D054304:Anti-Mullerian Hormone / Q000097:blood; D003226:Congresses as Topic; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins; D008597:Menstrual Cycle; D008875:Middle Aged; D006080:Ovarian Follicle / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000502:physiology; D010052:Ovariectomy; D012098:Reproduction / Q000502:physiology*; D014463:Ultrasonography
chemical_list: C422364:inhibin B; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone