The role of laparoscopic ovarian biopsy in the management of premature gonadal failure.

Approximately 1% of women enter menopause before 40 years of age. This premature event, however, is not as consequential when women have completed their reproductive lives as when they desire another pregnancy. When this latter situation does arise, the question facing the clinician is whether the ovaries still have follicles (resistant ovary syndrome) or they are depleted of these primordial follicles (premature menopause). The only way to demonstrate the presence of or absence of primordial follicles in the ovaries is by obtaining an adequate biopsy specimen for histopathologic diagnosis, a procedure that can be done via laparoscopy. This study had two purposes: one was to determine whether laparoscopic ovarian biopsy can provide an adequate specimen for histopathologic diagnosis safely and with low complication rates, and the other, to ascertain the relative frequency of premature menopause and resistant ovary syndrome.