Noninvasive diagnosis of resistant ovary syndrome by ultrasonography.

OBJECTIVE

To compare transvaginal ultrasonographic features of the ovaries and endometrium of patients with premature ovarian failure to normally cycling women on oral contraceptives (OCs), menopausal women with an equivalent duration of amenorrhea to the premature ovarian failure group, and patients with Turner's syndrome.

DESIGN

Transvaginal ultrasonography in groups of women with premature ovarian failure, OC, and menopause.

SETTING

All subjects were studied in an academic tertiary care center.

PATIENTS/PARTICIPANTS: Seventeen women with premature ovarian failure, 20 volunteers on OC, 20 with menopause, and 4 patients with Turner's syndrome were studied.

INTERVENTION

None, except for OCs in the OC group only.

MAIN OUTCOME MEASURES

Frequency of ovarian, ovarian follicle, and endometrial visualization and their respective measurement in the three groups.

RESULTS

At least one ovary was visualized in 84% of the premature ovarian failure patients as compared with 95% of the OC and menopause groups and 25% of the Turner patients. Mean ovarian volume was smaller in the premature ovarian failure group as compared with the OC group but equal to that of the menopause group. In the premature ovarian failure group, 41% had follicles in their ovaries as compared with 95% in the OC group, 5% in the menopause group, and none in the Turner group. The number of follicles per ovary was significantly lower in the premature ovarian failure as compared with the OC group, whereas only one subject had a single follicle in the menopause group. Premature ovarian failure subjects with follicles had larger ovaries than those without follicles. Endometrial thickness was not different among the groups.

CONCLUSION

Ultrasonography may serve to identify a substantial subset (approximately 40%) of premature ovarian failure patients with ovarian follicles and potential for fertility consistent with the diagnosis of resistant ovary syndrome.