Comparison of Dysplasia Profiles in Stimulated Ovaries and in Those with a Genetic Risk for Ovarian Cancer
G Chene, MM Dauplat, N Lagarde, F Mishellany, I Raoelfils, P Dechelotte, J Dauplat, FM Penault-Llorca. Centre Jean Perrin, Clermont-Ferrand, France; CHU, Clermont-Ferrand, France
Background: Ovarian epithelial dysplasia (OED) was first described after prophylactic oophorectomy for genetic risk of ovarian cancer. In light of Fathalla's incessant ovulation theory, this study was set up to describe the presence of ovarian abnormalities (dysplasia) after ovulation induction, and to compare dysplasia profiles in stimulated and genetic risk ovaries.
Design: One-hundred and twenty-five oophorectomies or ovarian cystectomies performed between 1992 and 2005 were reviewed. These were divided into three groups: (1) previous in vitro fertilization (n=37); (2) prophylactic oophorectomies for genetic risk (n=28); and (3) fertile non-cancerous controls (n=62). Eleven cytological and architectural epithelial features were defined and a dysplasia score was calculated to quantify ovarian epithelial abnormalities.
Results: Mean ovarian dysplasia score was significantly higher in the genetic risk and stimulated ovary groups than in controls (9.67 vs. 3.62, p<0.0001; 7.64 vs. 3.62, p<0.0002, respectively). Cytological and architectural ovarian abnormalities were more frequent in the genetic risk group, while the profile of abnormalities was different in the genetic risk and stimulated groups.
Conclusions: These findings support a possible relationship between OED and the use of ovulation-stimulating drugs. The increasing dysplasia score in genetic risk ovaries might be consistent with progression towards neoplastic transformation, and may justify the use of the term dysplasia or intraepithelial ovarian neoplasia. On the other hand, the fact that the dysplasia profile after stimulation differs from that in genetic risk ovaries may suggest that ovarian stimulation may predispose to a different evolution.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 11:00 AM
Platform Session: Section D, Tuesday Morning