Laparoscopy, ovarian and endometrial biopsies in secondary amenorrhea

A series of 114 patients complaining of secondary amenorrhea underwent laparoscopy and ovarian biopsy to evaluate ovarian function. Endometrial biopsy were performed on 81 patients. Smooth-inactive and polycystic-sclerocystic ovaries are the two more frequent gross ovarian findings. Normal ovarian histology was found in 61% of the series, Stein-Leventhal in 17% and ovarian fibrosis in 22%. Atrophic wrinkled ovaries should be biopsied to identify possible ovarian failure. Sclerocystic-polycystic, smooth-inactive, and normally active ovaries are not recommended for biopsy, since equally valuable information may be obtained from the gross ovarian appearance. Proliferative and atrophic endometrium are the two most frequent pathologic reports in secondary amenorrhea patients. Laparoscopic gross ovarian appearance, ovarian biopsy and endometrial biopsy should be considered as an alternative in the diagnostic management with secondary amenorrhea, when sophisticated laboratory assays are not readily available.