Clinical histologic correlation in reproductive pathology

Abstract

Background: In reproductive medicine, the ovary usually has been evaluated by clinical and hormonal parameters. The histopathologic analysis, though, may be a useful auxiliary tool in the diagnosis of ovarian pathology. However, it is not widely used because the pathologic report of the ovarian biopsy is not standardized.Objective: To correlate the clinical, hormonal, and histologic findings in a cohort of individuals with ovarian pathology.Methods: A sample of women with reproductive pathology was followed in a clinical design. Women were stratified into three groups: premature ovarian failure (POF), chronic anovulation, and low ovarian reserve. These groups were compared with a control group of healthy women. Ovarian function was determined by clinical and hormonal parameters, such as follicle-stimulating hormone, luteinizing hormone, prolactin, and E2 at the beginning of the menstrual cycle, and P4 in the 21st to 23rd day of the cycle. Endometrial biopsy was obtained by laparoscopy. Histologic description was conducted, blinded, by two pathologists whose techniques were previously standardized according to World Health Organization criteria. Analysis of variance was used to make comparisons among groups.Results: Fifty-two patients were studied: 21 with POF, 11 with chronic anovulation, 4 with low ovarian reserve, and 16 control patients. The group of patients with POF presented a significantly lower number of primordia, primary, and secondary follicles (P = 0.04). This group of women presented estromal and vascular alterations, but did not reach a statistical difference with the control group. Histologic description revealed a high correlation with the pathologic condition. There were no laparoscopic complications.Conclusions: Ovarian biopsy is a useful auxiliary for diagnosis in reproductive medicine.