Ovarian age – an early marker of premature ovarian insufficiency

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Abstract

Objective: To assess the degree of ovarian aging in patients with occult, biochemical, and overt ovarian insufficiency (POI) using the composite marker "ovarian age" (OvAge), calculated using the regression model proposed by Venturella R. et al. (2015).

Materials and methods: This cross-sectional study included patients with various clinical forms of POI (n=82) and women with preserved ovarian function (n=36) aged 18–39 years (mean age 33.1 (5.59) years). Follicle-stimulating hormone (FSH) and anti-Müllerian hormone (AMH) levels were measured on days 2–3 of the menstrual cycle, antral follicle count (AFC) was determined, and Doppler ultrasound of intraovarian blood flow was performed to calculate the vascularization index (VI) and blood flow index (FI).

Results: The OvAge was significantly higher in the POI group than in the control group. An additional marker, "excess chronological age", was calculated to represent the difference between the ovarian and chronological age of the patient. This excess was 1.25 (0.71) years in the control group, 6.63 (1.39) years in the latent POI group, 12.6 (0.98) years in the early POI group, and 18.91 (1.32) years in the overt POI group. The excess ovarian age over chronological age increases on average by six years as individuals transition from the group of healthy women to each subsequent POI group.

Conclusion: A gradual increase in ovarian age during the transition from latent to early and then to overt POI indicates progressive morphofunctional failure of the ovaries during disease development. The degree of excess ovarian age over chronological age allows for an assessment of the severity of changes in the primary POI markers measured in patients, providing a clearer reflection of the process of ovarian "aging" at different stages of the disease.

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About the authors

Roza I. Mashaeva

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Author for correspondence.
Email: i@mdrose.ru
ORCID iD: 0000-0001-5518-1572
SPIN-code: 6780-3831

PhD student, Department of Endocrinological Gynecology

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Larisa A. Marchenko

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: l_marchenko@yandex.ru

Dr. Med. Sci., Professor, Department of Endocrinological Gynecology

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Aleksandr I. Gus

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: a_gus@oparina4.ru
ORCID iD: 0000-0003-1377-3128

Dr. Med. Sci., Professor, Chief Researcher at the Department of Ultrasound and Functional Diagnostics

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

Kirill V. Kostyukov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: k_kostukov@oparina4.ru
ORCID iD: 0000-0003-3094-4013

Dr. Med. Sci, Head of the Department of the Ultrasound and Functional Diagnosis

Russian Federation, 117997, Moscow, Ac. Oparin str., 4

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2. Figure. ROC curve characterizing the relationship between the level of excess of chronological age and the presence of POI

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