Growth patterns of human ovarian volume during intrauterine and postnatal organogenesis

Abstract Background Ovarian volumes during pre-pubertal, reproductive or menopausal life in a healthy female have been studied by in vivo and anatomical methods. In contrast, conclusive studies on normal human ovarian volume during intrauterine and postnatal organogenesis, when the folliculogenesis occurs, do not exist. Aim To assess the growth patterns of ovarian volume during human ovarian definitive histogenesis using morphometric methods. Subjects Twenty-five left ovaries removed from fetuses, newborns and children with karyotype 46,XX, ranging from 15 to 74 weeks of development. Outcome measures The ovaries were completely cut obtaining serial sections. Ovarian volume was calculated both with the ellipsoid method, using its length, maximum and minimum diameters, and the Cavalieri quantitative morphometric method. The age-related pattern of ovarian volume was studied using linear regression analyses. Results Ovarian volume calculated with the Cavalieri method increased from 16 mm 3 at the 15th week of development to over 300 mm 3 at the end of the process, with a 20-fold increase compared to the initial volume. Ovarian volume calculated with the ellipsoid method ranged between 25 to over 380 mm 3 , with a 15-fold increase. On average, ellipsoidal volume over-estimated the true Cavalieri volume (mean difference −14%, S.D. 29, p =0.014, Student's t -test for paired samples). Linear regression curves were developed to predict ovarian volume at any age. Overall, the approximation was better for Cavalieri volume (approximately, 72% of variance explained by the linear regression) than for ellipsoid volume (59% of explained variance). Conclusions During the intrauterine and postnatal organogenesis, the normal growth rate of human ovary was almost linear. The calculation of ovarian volume using Cavalieri method does not depend on assumptions about the organ shape and it appears to be more appropriate.