Premature ovarian failure - definition / presentation and endocrine profile
premature atresia of ovarian follicles in women of reproductive age
- signs of menopause after puberty but before 40
endocrine profile: low estrogen, high LH, FSH
Polysystic ovarian (Stein-Leventhal) syndrome - mechanism
hyperinsulinemia and/or insulin resistance is hypothesized to alter hypothalamic hormonal feedback response –> high LH/FSH –> increased androgen production from theca cells (LH) (–> hirsutism) but low estrogen (no FSH on granulosa), low rate of follicular maturation –> unruptured follicles (cysts) + anovulation
Polysystic ovarian (Stein-Leventhal) syndrome - estrogen levels (mechanism)
Polysystic ovarian (Stein-Leventhal) syndrome - increased risk of … (and mechanism)
Ovarian cysts - types (MC?)
2. Theca lutein cyst
ovarian follicular cysts / associated with
distention of unruptured graafian follicle
associated with: 1. hyperestrogenism 2. endometrial hyperplasia
ovarian follicle cyst may be associated with
2. endometrial hyperplasia
Theca-lutein cyst - definition/mechanism / associated with
often bilateral/multiple due to gonadotropin stimulation
- choriocarcinoma / hydatidiform moles
increased risk for ovarian neoplasm
decreased risk for ovarian neoplasm
Benign ovarian neoplasms (MC?)
MC ovarian tumor in females 10-30
Mature teratoma of ovary (dermoid cyst)
Thecoma - characteristic, presentation
like granulosa cell tumors –> may produce estrogen
usually presents as abnormal uterine bleeding in postmenopausal women
malignant Ovarian neoplasms (MC?)
granulosa tumor - pathogenesis - histology
sex cord-stromal tumore
high estradiol and inhibin
- histology: Call-Exner bodies (cells in rosette pattern)
Granulosa cell tumor - clinical features
granulosa cell tumor - management
endometrial biopsy (endometrial cancer) surgery (tumor staging)
how to check the quality of ovaries
measure FSH at day 3
infertility due to diminished ovarian reserve - characteristics
regular menstrual cycles and decreased oocyte number + quality
ovarian cancer - screening
there is no screening
ovarian torsion - treatment
laparoscopy with detorsion
ovarian cystecomy
oophorectomy if nerosis or malignancy
ovarian torsion - RF
Causes of hyperandrogenism in pregnancy - types and risk for fetal virilization
Causes of hyperandrogenism in pregnancy - Krukenberg tumor - maternal clinical features
bilateral solid ovarian masses on U/S
metastases from GI tract ca