Mills Ginevra, Goorah Bernice, Elizur Shai E, Son Weon-Young, Dahan Michael H
Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, Canada.
Department of Obstetrics and Gynecology, McGill University, Montreal, Canada.
Turk J Obstet Gynecol. 2022 Sep 23;19(3):215-220. doi: 10.4274/tjod.galenos.2022.63255.
This study aimed to examine the associations between follicular distribution pattern (FDP) in polycystic ovaries and menstrual disturbances in women with infertility.
A retrospective review of patients was performed (n=73). Ultrasound images from cycle day 2-5 of a spontaneous or progestin induced menstrual cycle were reviewed. Ovaries were classified as polycystic ovarian morphology (PCOM) if they contained ≥12-follicles measuring 2-9 mm in diameter. Images of PCOM ovaries were classified as having a peripheral cystic pattern (PCP) with follicles arranged at the periphery of the ovary, or general cystic pattern (GCP) if follicles were dispersed heterogeneously throughout the ovarian stroma. Menstrual disturbance was assessed by questionnaire, and oligomenorrhea was defined as cycles >35 days in length.
PCP was more strongly associated with menstrual irregularity that GCP. 94% of subjects with bilateral PCP-experienced oligomenorrhea compared with 65% of women with a unilateral PCP ovary [odds ratio (OR) 9; p<0.05]. 29% of women with bilateral GCP ovaries experienced menstrual disturbances, less than bilateral PCP (OR 36; p=0.002), but similar to unilateral PCP (OR 3; p=0.07). Serum testosterone and luteinizing hormone (LH) levels were significantly correlated with the ovarian FDP.
There is a relationship between menstrual irregularity or certain types of serum steroids and ovarian morphology. It remains unknown if morphology, testosterone or LH causes the menstrual disturbance or if they are co-initiated by an intervening factor.
本研究旨在探讨多囊卵巢中卵泡分布模式（FDP）与不孕症女性月经紊乱之间的关联。
对患者进行回顾性研究（n = 73）。回顾自发或孕激素诱导月经周期第2 - 5天的超声图像。如果卵巢中含有≥12个直径为2 - 9 mm的卵泡，则将其分类为多囊卵巢形态（PCOM）。PCOM卵巢的图像如果卵泡排列在卵巢周边则分类为周边囊性模式（PCP），如果卵泡在整个卵巢基质中不均匀分布则分类为一般囊性模式（GCP）。通过问卷调查评估月经紊乱情况，月经过少定义为月经周期>35天。
PCP比GCP与月经不规律的关联更强。双侧PCP的受试者中有94%出现月经过少，而单侧PCP卵巢的女性中这一比例为65%[优势比（OR）9；p<0.05]。双侧GCP卵巢的女性中有29%出现月经紊乱，低于双侧PCP（OR 36；p = 0.002），但与单侧PCP相似（OR 3；p = 0.07）。血清睾酮和促黄体生成素（LH）水平与卵巢FDP显著相关。
月经不规律或某些类型的血清类固醇与卵巢形态之间存在关联。目前尚不清楚是形态、睾酮还是LH导致月经紊乱，或者它们是否由一个中间因素共同引发。
