Ovarian Reserve Condition in Women with Menstrual Dysfunction in the Puberty

Abstract

The concept of «ovarian reserve» in recent years has been widely discussed in the literature. This is a functional reserve of the ovaries, reflecting the size of the follicular pool of the ovaries and the quality of the oocytes in them, that is, it characterizes the ability of the ovaries to develop a healthy follicle with a full egg. Determination of ovarian reserve allows you to more accurately assess the reproductive potential of women and prevent pathological conditions and diseases that reduce fertility.The objective: аccording to laboratory and instrumental methods of research, to give a comprehensive assessment of the condition of the ovarian reserve in women with menstrual dysfunction in the puberty.Materials and methods. The main group of women (n=90) with a pathology of menstrual function in the puberty, according to the nature of the violations, was divided into 3 subgroups (n=30): the first – women with primary oligomenorrhea in the anamnesis, the second – with late age menarche, the third – with puberty bleeding. The control group consisted of women (n=30) with the correct rhythm of menstruation in puberty. The age range of the subjects is from 19 to 32 years. The biochemical and echographic markers of the ovarian reserve were studied.Results. In a clinical study, it was found that in women with menstrual dysfunction in the puberty, the concentration of antimuller hormone (AMH) in the blood serum and the size of the ovaries (total volume) are greater due to the greater number of small follicles compared to women in the control group. A direct correlation between the parameters of AMH and the number of follicles and the inverse between AMH and the diameter of the follicles indicate normal ovarian reserve. This pattern was observed in women with a primary history of oligomenorrhea and late menarche. In women with pubertal hemorrhages, the concentration of AMH in the blood did not significantly differ from the control group, the total volume of both ovaries was greater than in women with a normal rhythm of menstruation (p<0,05), but the total number of follicles did not differ significantly. The correlation between the total volume of both ovaries and the total number of follicles was lost, which may indicate an increase in ovarian volume due to the stromal component.Conclusion. A comprehensive analysis of the level of AMH in serum, the total volume of the ovaries and the number of follicles in the preovulatory period allows us to estimate the ovulatory reserve in women with menstrual dysfunction in the pubertal period. And although the indicated parameters in the examined women are significantly higher than in women with the correct rhythm of menstruation (p<0,05), they remain within the reference values, which indicates the preservation of their ovarian reserve. Today, for screening the ovarian reserve, determining the concentration of AMH in the blood serum has several significant advantages over other methods, because this hormone is a marker that begins to change with age before other indicators, which is of great prognostic value in the treatment of various disorders of the reproductive system, premature extinction its function and infertility.