Chene Gautier, Penault-Llorca Frédérique, Tardieu Anne, Cayre Anne, Lagarde Nicole, Jaffeux Patricia, Aublet-Cuvelier Bruno, Dechelotte Pierre, Felloni Bertrand, Pouly Jean-Luc, Dauplat Jacques
Department of Histopathology, Centre Jean Perrin, Clermont-Ferrand 63000, France.
Obstet Gynecol Int. 2012;2012:429085. doi: 10.1155/2012/429085. Epub 2012 Feb 9.
Aim. Ovarian epithelial dysplasia was initially described in material from prophylactic oophorectomies performed in patients at genetic risk of ovarian cancer. Similar histopathological abnormalities have been revealed after ovulation stimulation. Since infertility is also a risk factor for ovarian neoplasia, the aim of this study was to study the relationship between infertility and ovarian dysplasia. Methods. We blindly reviewed 127 histopathological slides of adnexectomies or ovarian cystectomies according to three groups-an exposed group to ovulation induction (n = 30), an infertile group without stimulation (n = 35), and a spontaneously fertile control group (n = 62)-in order to design an eleven histopathological criteria scoring system. Results. The ovarian dysplasia score was significantly higher in exposed group whereas dysplasia score was low in infertile and control groups (resp., 8.21 in exposed group, 3.69 for infertile patients, and 3.62 for the controls). In the subgroup with refractory infertility there was a trend towards a more severe dysplasia score (8.53 in ovulation induction group and 5.1 in infertile group). Conclusion. These results raise questions as to the responsibility of drugs used to induce ovulation and/or infertility itself in the genesis of ovarian epithelial dysplasia.
目的。卵巢上皮发育异常最初是在对有卵巢癌遗传风险的患者进行预防性卵巢切除术的材料中描述的。排卵刺激后也发现了类似的组织病理学异常。由于不孕症也是卵巢肿瘤的一个危险因素，本研究的目的是探讨不孕症与卵巢发育异常之间的关系。方法。我们根据三组对127例附件切除术或卵巢囊肿切除术的组织病理学切片进行了盲法评估，这三组分别是排卵诱导暴露组（n = 30）、无刺激的不孕组（n = 35）和自然受孕对照组（n = 62），以便设计一个包含11项组织病理学标准的评分系统。结果。暴露组的卵巢发育异常评分显著更高，而不孕组和对照组的发育异常评分较低（暴露组分别为8.21，不孕患者为3.69，对照组为3.62）。在难治性不孕亚组中，有发育异常评分更严重的趋势（排卵诱导组为8.53，不孕组为5.1）。结论。这些结果引发了关于用于诱导排卵的药物和/或不孕症本身在卵巢上皮发育异常发生中的责任的问题。
