A postmortem study-age related change of ovarian volume in Bangladeshi female

Assistant Professor, Department of Anatomy, East West Medical College, Dhaka, Bangladesh. Professor & Head, Department of Anatomy, Sir Salimullah Medical College, Dhaka, Bangladesh. Assistant Professor, Department of Anatomy, East West Medical College, Dhaka, Bangladesh. Assistant Professor, Department of Anatomy, East West Medical College, Dhaka, Bangladesh. Assistant Professor, Department of Anatomy, Medical College for Women, Dhaka, Bangladesh.


INTRODUCTION
Ovary undergoes various changes under the influence of hormones which starts from prepubertal period and continues up to post menopausal period 1 .In the young adult, they are almond shape, solid and white in colour, approximately 3cm long, 1.5cm wide and about 1cm thick.The average volume of the ovary is 9.4cm 2 with peak volume being recorded during the third decade of life 2 .Ovary is essential for periodic release of oocytes and the production of steroid hormones-estrogen and progesterone.These hormones control the development of secondary sexual characteristics at the time of puberty.These activities are integrated into cyclic repeatitive process of follicular maturation, ovulation with formation and regression of corpus luteum under the control of the hypothalamo-hypophyseal system 3 .
There is a significant correlation between length, breadth & thickness of the ovary with ovarian volume which may further determine the ovarian reserve and reproductive age of female 4 .The fertility decline in women after the age of 30 years and striking decrease is observed after 35 years of age and completely lost by 45 years of age.This age related decline in fertility results from several factors that contribute to overall reproductive failure including inadequate thickness of endometrium and poor oocyte quality 5 .By applying the accurate and efficient methods for estimating the volume of the ovaries, ovarian aging process can be assessed 6 .The repetitive growth and regression of intra ovarian structures appears to predispose this major organ to development of multiple abnormalities of structure and functions 7 , that frequently cause menstrual and fertility problems 8 .The most common group of ovarian tumour is ovarian cancer (90%) 9  Infertility rate is gradually increasing day by day in all over the world and one of the main causes of it is abnormalities of the ovarian functions as well as the ovarian diseases 11 .Follicular depletion and reduction in ovarian volume leading to decrease the fertility of a women.The decreased fertility with increasing female age appears to diminish the quality of existing oocytes and the diameter of growing follicles.By Assisted reproductive technology (ART), an infertile couple is used to help to conceive by artificial or partially artificial means and manage the infertility problem.It works by removing eggs from a woman's body, which are then mixed with sperm to be fertilized into embryos.These embryos are then put back in the womb for pregnancy 12 .

Materials & methods
The present study was performed on 65(sixty five) pairs of postmortem human ovaries.Samples were collected from unclaimed dead bodies within 12  Ovaries were collected from the cadavers by the standard postmortem techniques.After removal from the dead body, the ovaries were brought to the Anatomy department of SSMC and washed gently and thoroughly with running tap water to remove blood and blood clots as far as possible.
Each sample was tagged properly bearing an identification number with the age of the cadaver.The samples were preserved in 10% formol saline solution for fixation.
Volume of each ovary was measured by applying the ellipsoid formula 14 which requires the measurement of the three dimensions-length, breadth and thickness of the ovary.The length, breadth and thickness were measured by using digital vernier calipers in millimeter.The length of the ovary were measured from its one pole to another pole [fig. 1

RESULTS
In

DISCUSSION
In the present study, the highest mean (± SD) volume were observed in reproductive age (group B) and the lowest volume were in postmenopausal age (group D) when compared among the age groups.The values were non significant (P>0.50)when compared between right and left ovaries.The volume of the ovary increased from prepubertal age (group A) and reaches its maximum up to reproductive age (group B).After that they gradually begins to decline from perimenopause (group C) and become static at postmenopause (group D).
Pavlik et al 15  This research was carried out to investigate the volume of ovary of Bangladeshi female population, in order to improve the anatomical knowledge of volume of ovary, especially in relation to age.This values regarding volume ovary will also provide an essential data in our country and also will be a pre-requisite for compare the data with other countries.So the study will provide a more complete data and standarize the data in Bangladeshi female population.It will make available resourcefull information for improving the accurate diagnosis and management of ovarian diseases as well as infertility problems with assisted reproductive technologies (ART).

Conclusion:
In this study, volume of the ovary does not vary in between right and left ovary in any age group.Volume of the ovary also does not vary significantly between in prepubertal age group and postmenopausal age group.
(A)], breadth of the ovary were measured at the region of the highest transverse diameter [fig.1(B)] and thickness were measured at the region of maximum antero-posterior diameter [fig.1(C)]All measurements were done three times and the mean values were taken and then each mean values were converted into centimeters.

Fig. 2
Fig. 2Mean (±SD) volume of the right and left ovaries in different age groups

Age distribution of sangle group. Study group distribution in different age groups Study groups Age range (in years) No. of samples (n = 65x2=130)
Tabel 1:

Table 2 .
Mean (±SD) volume of the right and left