Ovarian morphologic features and endocrine profile in amenorrheic patients

Ovarian morphologic features and endocrine profile were investigated in 20 patients with primary amenorrhea and 41 patients with secondary amenorrhea. In light of macroscopic and microscopic findings, it was possible to distribute the anovulatory ovaries into the following six main types: (1) polycystic; (2) sclerotic; (3) normotrophied; (4) hypoplastic; (5) atrophic, and (6) streak. Anovulatory ovaries with or without follicles in an early developmental stage, such as the streak or hypoplastic type, were found in patients with primary amenorrhea. In contrast, ovaries with follicles in a late developmental stage, such as the polycystic, sclerotic and normotophied type, were seen in patients with secondary amenorrhea. A close correlation between ovarian morphologic features and hormonal parameters, such as serum FSH and LH levels, and the 24-hour urinary excretion of total estrogens was proved. From the present results, visualization of the ovaries and histologic examination of tissue obtained by biopsy might be an accepted part of the investigation of patients with primary and secondary amenorrhea, particularly those also complaining of infertility. It is no longer justified to postpone investigation until the infertile patients have proved their infertility over several years of a barren, marriage, and ovarian stimulation should be considered at an early stage.