Abstract
The measurement of ovarian volume has been shown to be a useful indirect indicator of the ovarian reserve in women of reproductive age, in the diagnosis and management of a number of disorders of puberty and adult reproductive function, and is under investigation as a screening tool for ovarian cancer. To date there is no normative model of ovarian volume throughout life. By searching the published literature for ovarian volume in healthy females, and using our own data from multiple sources (combined n = 59,994) we have generated and robustly validated the first model of ovarian volume from conception to 82 years of age. This model shows that 69% of the variation in ovarian volume is due to age alone. We have shown that in the average case ovarian volume rises from 0.7 mL (95% CI 0.4–1.1 mL) at 2 years of age to a peak of 7.7 mL (95% CI 6.5–9.2 mL) at 20 years of age with a subsequent decline to about 2.8 mL (95% CI 2.7–2.9 mL) at the menopause and smaller volumes thereafter. Our model allows us to generate normal values and ranges for ovarian volume throughout life. This is the first validated normative model of ovarian volume from conception to old age; it will be of use in the diagnosis and management of a number of diverse gynaecological and reproductive conditions in females from birth to menopause and beyond.
Highlights
The main functions of the ovary are to provide gametes and sex steroids to allow and support the establishment of pregnancy, and act as a repository for the non-growing follicles (NGFs) that allow this process to take place over several decades
The model has coefficient of determination r2~0:69 indicating that around 69% of the variation in ovarian volumes throughout life is due to age alone
Our model shows that in the average case ovarian volume rises from 0.7 mL at 2 years of age to a peak of 7.7 mL at 20 years of age
Summary
The main functions of the ovary are to provide gametes and sex steroids to allow and support the establishment of pregnancy, and act as a repository for the non-growing follicles (NGFs) that allow this process to take place over several decades. The human ovary establishes its complete complement of non-growing follicles during fetal life, and after birth there is a continuous process of recruitment until menopause at an average age of 50–51 years, when fewer than one thousand remain [1,2,3]. We have shown a strong and positive correlation between ovarian volume and NGF population in the human ovary for ages 25–51 years [10], but there is only sparse information available on ovarian volume in healthy young girls and women [11]. A greater understanding of the changes in ovarian volume throughout life are likely to be helpful in the diagnosis and treatment of many disorders in gynaecology and reproductive medicine [12]
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