Indications for and limitations of laparoscopic ovarian biopsy

A series of 213 patients with different menstrual patterns underwent laparoscopic visualization of the ovaries and ovarian biopsy in order to evaluate ovarian function. Menstrual patterns were classified in four groups: regular menstrual cycles, oligoamenorrhea, secondary amenorrhea and primary amenorrhea. Laparoscopic gross ovarian appearance was classified in four groups, also. Microscopic picture of the ovaries was also placed in four categories. Laparoscopic vision of the ovaries is not justified in regular menstrual cycle patients. Laparoscopic vision of the ovaries might be useful when menstrual disorders exist, especially in secondary amenorrhea. There is some controversy about whether primary amenorrhea patients should be biopsied. Histology may be important in x,y karyotype primary amenorrhea. Biopsy should be avoided in oligoamenorrhea patients. Premature menopause might be diagnosed histologically in patients with secondary amenorrhea. Gross ovarian appearance may help in the selection of patients for ovarian biopsy. Sclerocystic polycystic ovaries should be biopsied, but the procedure must be bloodless and correctly performed. Streak gonad biopsy is not without hazard, and ureteral injury has been reported. The diagnostic, prognostic and therapeutic value of ovarian biopsy should be balanced against the risk and expense of the procedure.