Three-dimensional microanatomical dynamics of the ovary in postreproductive aged women

Abstract

Objective: To evaluate the microanatomical dynamics of the ovary during postreproductive life. Design: Retrospective, observational research study. Setting: Institutional (university). Patient(s): Eleven (43- to 72-year-old) women in perimenopause, menopause, or postmenopause. Intervention(s): Biopsies of ovaries obtained from patients undergoing gynecologic surgery or diagnostic procedures. Main Outcome Measure(s): Analysis of the 3-dimensional microanatomy of the ovary by transmission and high-resolution scanning electron microscopy. Result(s): The surface epithelium gets gradually flatter and is always present, even in advanced age. The surface appears smoother because of a smaller number of papillae and crypts as well as a decreased number and shortening of microvilli on surface epithelial cells. Signs of atrophy and fibrosis are evident. Primordial follicles are usually absent in postmenopause, whereas corpora atretica, hemorrhagica, and albicantia, scar tissue, and simple follicular cysts are common after menopause. Apoptotic and necrotic cells appear frequently within the surface epithelium. Major common features are a marked reduction in number and caliber of blood vessels with thickening of the vascular walls and changes in endothelial cells. Conclusion(s): Scanning electron microscopy studies are a useful complement to ordinary gynecologic diagnostic methods. Variations among patients of the same age range or functional status should be considered.