Background: Obesity is an increasingly common health problem which has been found to affect female reproductive function in several aspects. The aim of our study was to determine the ovarian ultrasound features in women with morbid obesity.
Methods: We performed a cross sectional study in 50 women with a body mass index (BMI) ≥40 kg /m2 collected over a period of 6 months (October 2017March 2018). For each woman, a sus-pubic ultrasound was performed during the early follicular phase. In each ovary, the total number of small follicles (210 mm) was counted and the ovary volume was determined.
Results: The average age of our patients was 34.2±7.51 years and their mean BMI was 44.53±3.97 kg/m2. The mean volume of the right and left ovary was 10.3±5.8 ml and 10±5.5 ml, respectively. Thirty four percent of our women had an ovarian volume greater than 10 ml. The mean antral follicular count was 5.0±3.8 follicles in the right ovary and 4.8±3.5 in the left one. This antral follicular count was greater than 12 in 12% and correlated positively with the BMI (r=0.29, P=0.06), insulinemia (r=0.5; P=0.001) and the Homa index (r=0.57; P<0.001). Thirty six percent of our patients had a polycystic ovary aspect at ovarian ultrasound. Polycystic ovary syndrome (PCOS) was diagnosed in 40% of cases. Only the ovarian volume >10 ml was significantly associated with PCOS (OR=11, P=0.001).
Conclusion: This study showed that the ovarian morphology may change in obese patients specifically the finding of a multifollicular appearance or enlarged ovaries. This may be explained by the effect of hyperinsulinemia and the excess of LH caused by obesity on ovarian size.
18 - 21 May 2019
European Society of Endocrinology