Ovarian age – an early marker of premature ovarian insufficiency
Mashaeva R.I., Marchenko L.A., Gus A.I., Kostyukov K.V.
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.
Authors' contributions: Mashaeva R.I. – review of relevant literature, structuring, collection of materials, acquisition and analysis of data, statistical analysis, drafting of the manuscript; Marchenko L.A. – conception and design of the study, structuring and editing of the manuscript; Gus A.I., Kostyukov K.V. – collection of materials, acquisition and analysis of data.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the V.I. Kulakov NMRC for OG&P.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Mashaeva R.I., Marchenko L.A., Gus A.I., Kostyukov K.V.
Ovarian age – an early marker of premature ovarian insufficiency.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (3): 120-127 (in Russian)
https://dx.doi.org/10.18565/aig.2024.271
Keywords
premature ovarian insufficiency (POI)
occult POI
anti-Müllerian hormone (AMH)
follicle-stimulating hormone (FSH)
three-dimensional echography
antral follicle count (AFC)
VI
FI
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Received 29.10.2024
Accepted 12.02.2025
About the Authors
Roza I. Mashaeva, PhD student, Department of Endocrinological Gynecology, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,117997, Russia, Moscow, Ac. Oparina str., 4, +7(909)933-64-76, i@mdrose.ru, SPIN: 6780-3831, https://orcid.org/0000-0001-5518-1572
Larisa A. Marchenko, Dr. Med. Sci., Professor, Department of Endocrinological Gynecology, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparina str., 4, +7(495)438-85-40, l_marchenko@yandex.ru
Aleksandr I. Gus, Dr. Med. Sci., Professor, Chief Researcher at the Department of Ultrasound and Functional Diagnostics, V.I. Kulakov NMRC for OG&P,
Ministry of Health of Russia, 117997, Russia, Moscow, Ac. Oparina str., 4, +7(495)438-11-77, a_gus@oparina4.ru, https://orcid.org//0000-0003-1377-3128
Kirill V. Kostyukov, Dr. Med. Sci, Head of the Department of the Ultrasound and Functional Diagnosis, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
117997, Russia, Moscow, Ac. Oparin str., 4, +7(495)438-11-77, k_kostyukov@oparina4.ru, https://orcid.org/0000-0003-3094-4013
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