Pache T D, Chadha S, Gooren L J, Hop W C, Jaarsma K W, Dommerholt H B, Fauser B C
Department of Obstetrics and Gynaecology, Dijkzigt University Hospital, Rotterdam, The Netherlands.
Histopathology. 1991 Nov;19(5):445-52. doi: 10.1111/j.1365-2559.1991.tb00235.x.
Descriptions of the effect of androgens on ovarian human tissues are exceptional. This opportunity was provided for us by 17 women with transsexualism--female to male transsexuals (TSX)--who had been given androgens for a mean period of 21 months before hystero-salpingo-oophorectomy took place. Twenty-nine ovaries from TSX and 14 control ovaries from 13 regularly cycling women were examined. As compared with controls, TSX ovaries were enlarged and displayed a two-fold increase in cystic follicles and a 3.5-fold increase in atretic follicles; the ovarian cortex was collagenized and three-times thicker. Theca interna hyperplasia and luteinization were uniformly observed in TSX cystic follicles. Stromal hyperplasia was a constant finding in TSX ovaries, accompanied by clusters of luteinized stromal cells in 12 cases. Eventually, these findings met the histological criteria for the diagnosis of polycystic ovaries. These observations demonstrate that androgens alone may induce polycystic changes. The assumption that the role of androgens is pivotal at the follicular level--inducing follicle growth arrest and accelerating cystic changes--in the genesis of polycystic ovaries is reinforced.
关于雄激素对人体卵巢组织影响的描述极为罕见。17名变性女性——女变男的变性者（TSX）为我们提供了这样一个机会，她们在接受子宫输卵管卵巢切除术之前平均服用雄激素21个月。对来自TSX的29个卵巢和来自13名月经周期正常女性的14个对照卵巢进行了检查。与对照组相比，TSX卵巢增大，囊性卵泡增加两倍，闭锁卵泡增加3.5倍；卵巢皮质胶原化，厚度增加两倍。在TSX囊性卵泡中均观察到卵泡内膜增生和黄素化。基质增生在TSX卵巢中是一个持续存在的现象，12例伴有黄素化基质细胞簇。最终，这些发现符合多囊卵巢诊断的组织学标准。这些观察结果表明，仅雄激素就可能诱导多囊性改变。雄激素在多囊卵巢发生过程中在卵泡水平起关键作用——诱导卵泡生长停滞并加速囊性改变——这一假设得到了加强。
