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The aim of this study was to investigate the effects of endometrioma (OMAs) size and bilaterality on ovarian reserve. The patients with OMA were determined by ultrasonographic examination. Fifty patients with unilateral OMA (Group A), 30 patients with bilateral OMA (Group B), and 60 women without ovarian cysts (Group C) were included in this study. AMH levels were measured, and antral follicle count (AFC) was determined. The mean serum AMH levels were significantly lower in Group B than Groups C and A, and were significantly lower in Group A than Group C. There was a significant correlation between serum AMH level and OMA size in Group A ( R  = -.372, p  = .008). OMAs per se appear to be associated with damage to the ovarian reserve. Increased OMA size is related to decreased AMH levels in patients with OMA. Bilateral OMAs have a more destructive effect on ovarian reserve.IMPACT STATEMENT What is already known on this subject? Previous Studies have demonstrated the effect of surgery on ovarian reserve but there have been contradictory findings reported about the effects of OMAs per se on serum AMH levels and it has not been clear what the relation between OMAs size and AMH levels is, if any. What the results of this study add? In this study, we found decreased AMH levels in patients with OMA. The results showed significant negative correlation between OMA size and AMH levels. The patients with bilateral OMAs had lower AMH levels than the unilateral ones. What the implications are of these findings for clinical practice and/or further research? Increasing OMA size might be harmful to ovarian reserve. Further studies should be done to evaluate whether increasing the size of the OMA is associated with a progressive decline in ovarian reserve and to better clarify the role of the OMAs per se or of laparoscopic surgery in the determination of damage to the ovarian reserve.

Background: Undescended ovaries are typically detected during infertility evaluations and are frequently associated with uterine malformations. Ruptured hemorrhagic corpus luteum cyst of an undescended ovary is an unusual cause of acute abdomen in an adolescent., Case: A 15-year-old girl presented with right lower quadrant pain, nausea, and vomiting, and transabdominal sonography and magnetic resonance imaging of the pelvis showed a 10 cm × 5 cm sized cystic mass at the level of the pelvic brim, anterior to the psoas muscle suggestive of a retroperitoneal hemorrhagic cyst. At surgery, the uterus and left adnexa appeared normal, but the right ovary was not visible within the pelvic cavity, and the right pelvic retroperitoneum was distended. After opening the retroperitoneum and aspirating blood clots, the undescended ovary with a ruptured cyst was visualized within the retroperitoneum. Right ovarian wedge resection was performed and the right ovary was repositioned in the pelvic cavity., Summary and Conclusion: Rupture of a corpus luteum cyst in an undescended ovary should be included in the differential diagnosis of acute abdomen in adolescents., (Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.)

Nutcracker syndrome (NCS), a rare clinical entity, when refractory to medical management warrants surgical intervention. In the following discussion, we present a case of NCS which was managed successfully by left renal vein transposition using a decompression shunt., (Copyright © 2014 Elsevier Inc. All rights reserved.)

We report the case of a female adolescent who had an ectopic ovary in the inguinal canal without an associated hernia, a unicornuate uterus, and ipsilateral renal agenesis. The incidental discovery of the ectopic ovary and other Mullerian anomalies, as well as the surgical correction that followed, highlights important fertility considerations in children and available treatment algorithms for these rare cases.

Ovarian torsion may have significant fertility implications. Interleukin-6 is a pro-inflammatory cytokine, which may act as a helpful diagnostic test. Our objective was to investigate the accuracy of serum interleukin-6 in the diagnosis of ovarian torsion in women with ultrasonographic evidence of an ovarian cyst. An electronic search of published data, unpublished dissertations, theses and conference proceedings was performed. The systematic review involved observational studies. The studies had to provide data to construct 2 × 2 tables. A modified QUADAS tool was used to assess the quality of studies. Sensitivity, specificity, positive and negative predictive value, likelihood ratios and diagnostic odds ratios were calculated. Three studies were identified. Two were included in the meta-analysis. The prevalence of torsion was 30% (21/70). The pooled sensitivity was 85.1% and the pooled specificity was 84.1%. Although further cohort studies would be required, there may be a role for interleukin-6 in the diagnosis of ovarian torsion.

Context: Endometriomas are mainly treated surgically. However, there has been concern over the potential damaging effect of this surgery on ovarian reserve., Objective: The aim of this meta-analysis was to investigate the impact of surgery for endometriomas on ovarian reserve as determined by serum anti-müllerian hormone (AMH)., Data Sources: MEDLINE, PubMed, and Embase were searched electronically., Study Selection: All prospective cohort studies that analyzed changes of serum AMH concentrations after surgical treatment of endometriomas were eligible. Twenty-one studies were identified, of which eight were selected for meta-analysis., Data Extraction: Two reviewers performed the data extraction independently., Data Synthesis: Pooled analysis of 237 patients showed a statistically significant decrease in serum AMH concentration after ovarian cystectomy (weighted mean difference -1.13 ng/ml; 95% confidence interval -0.37 to -1.88), although heterogeneity was high. Sensitivity analysis for studies with a preoperative serum AMH level of 3.1 ng/ml or greater improved heterogeneity but also still showed a significant postoperative fall in serum AMH (weighted mean difference -1.52 ng/ml, 95% confidence interval -1.04 to -2)., Conclusion: The results of this study suggest a negative impact of excision of endometriomas on ovarian reserve as evidenced by a significant postoperative fall in circulating AMH.

Ovarian torsion requiring surgical intervention in pregnancy is rare. Herein is reported a case of ovarian torsion that was managed by transvaginal ovarian cystectomy in a 27 week gravid patient., (Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate the blood flow changes and their relationships to microvessel density (MVD) and thrombospondin-1 (TSP-1) by transvaginal colour Doppler sonography (TV-CDS) in the ovarian interstitium to predict ovarian interstitial microvascular injury in the pathological process of ovarian endometrial cysts (OEC)., Methods: TV-CDS was preoperatively performed to detect blood flow changes in 60 patients with 76 ovarian endometrioid cysts, and flow classification and resistance indices (RI) values were recorded for analysis. Ovarian interstitial specimens with blood flow signals were collected for postoperative pathologic examination. TSP-1 protein was evaluated by immunohistochemistry and Western blot, TSP-1 mRNA by reverse transcriptase polymerase chain reaction, microvessels by CD34 antibody, and MVD by image analysis. Thirty age-matched patients with benign ovarian tumours served as controls., Results: Blood flow, most of star-shaped, within ovarian interstitial arteries in the OEC group was diminished; however, arterial spectra exhibited a high-resistance flow manifesting a significantly higher RI compared with that of the control group (P < 0.01). In ovarian interstitial specimens, there were significantly (P < 0.01) lower CD34-MVD and higher TSP-1 protein and mRNA in the OEC group than in the controls. CD34-MVD and TSP-1 showed remarkably negative correlation (rs = -0.76, P < 0.01). RI values correlated negatively with MVD values (rs = -0.91, P < 0.01), but positively with TSP-1 (rs = 0.81, P < 0.01), while flow classification correlated positively with MVD values (rs = 0.66, P < 0.01), but negatively with TSP-1 (rs = -0.54, P < 0.01)., Conclusions: Changes in CD34-MVD and TSP-1 reflected ovarian interstitial microvascular injury of OEC, pathologically supported the findings of blood flow changes within ovarian interstitial arteries, and prospectively predicted OEC-induced ovarian interstitial vessel injury. This has important clinical value: early treatment, instead of allowing the cyst to become bigger, is of great importance for OEC patients, because a greater number of functional tissue blood vessels would be destroyed as the disease progresses.

Study Objective: To study clinical features of patient presented with severe hydramnios, associated with hydronephrosis, that was antenatally diagnosed and has been successfully treated immediately after birth. At a molecular level, we investigated the gene expression of key steroidogenic enzymes from the maternal ovary., Design: Ultrasound scan, MRI, semi-quantitative RT-PCR SETTING: The patient was admitted to the University Hospital, University of Crete, Medical School, Greece, where all clinical data has been obtained. Gene expression studies took place at Biosciences, Brunel University, UK., Results: Semi-quantitative RT-PCR analyses revealed that there is upregulation of key steroidogenic genes in the maternal ovary, including steroidogenic acute regulatory protein, and the cytochrome P450 heme-containing proteins CYP11A, CYP17 and CYP19. From a clinical perspective, the prenatal ultrasound scan and MRI findings showed a multicystic pelvic mass, bilateral hydronephrosis and prior to delivery severe polyhydramnios., Conclusion: This clinical case is the only one that we have found in the current literature where congenital imperforate hymen accompanied with hematocolpos is associated with renal obstruction in combination with polyhydramnios and increase in maternal steroidogenic enzymes., (Copyright 2010. Published by Elsevier Inc.)

Objective: To describe a woman with postmenopausal virilization and hirsutism caused by hilus-cell hyperplasia., Methods: We present a case report including laboratory, radiographic, and pathologic findings in a patient with postmenopausal hirsutism and virilization caused by ovarian hilus-cell hyperplasia as well as a brief review of the literature., Results: A 60-year-old postmenopausal woman presented with extensive hirsutism, male-pattern hair loss, and clitoromegaly. The patient's plasma testosterone levels were very high, but computed tomography showed the adrenal glands to be normal in size. Pelvic ultrasonography revealed a cystic lesion in the left ovary. After bilateral salpingo-oophorectomy, histologic examination demonstrated a diffuse pattern of hilus-cell hyperplasia in the ovarian hilum., Conclusion: In the differential diagnosis of postmenopausal virilization, hilus-cell hyperplasia, although rare, should be considered.

Objective: To add further data on in vitro fertilization (IVF) outcome and ovarian response after endometrioma stripping via either laparoscopy or laparotomy., Study Design: IVF outcome and ovarian response parameters in patients who had undergone unilateral endometrioma stripping at laparoscopy (n=28) or laparotomy (n=10) before IVF were retrospectively compared., Results: Fertilization rates, number of embryos transferred and pregnancy rates did not differ between the groups. Significantly more recombinant FSH was used to induce folliculogenesis, and fewer metaphase II oocytes were retrieved in the laparotomy group. The laparotomy-postcystectomy ovaries were significantly smaller and malpositioned. In both stripping groups, significantly smaller operated-on ovaries with lower numbers of antral and mature follicles were observed as compared to intact ovaries., Conclusion: A higher amount of FSH is needed to achieve an acceptable IVF outcome after unilateral endometrioma surgery. Indications for surgical treatment of patients having larger and bilateral cysts with an expectation for future fertility should be cautiously reviewed

A 30-year-old woman with a history of endometriosis and chronic pelvic pain had right-sided pain and sonographic evaluation demonstrated a right ovarian cyst 5 cm in diameter. Laparotomy revealed a right ovarian cystic mass and the cystic mass was found on the sigmoid colon. After excision, histopathologic study revealed endometrioma for the ovarian cyst and a supernumerary ovary for the cystic mass on the sigmoid colon.

Gonadal hyperfunction is the most frequent endocrine dysfunction in females with McCune-Albright syndrome (MAS). Peripheral precocious puberty is usually the first MAS manifestation in children, characterized by episodes of hypersecretion of estrogens with a consequent reduction in gonadotropin secretion. Little is known about the course of this endocrine disease in adolescence and during young adult life. The aim of this study was to evaluate ovarian function in 10 females with MAS (age 11.4-20.1 years) to detect the persistence of autonomous ovarian hyperfunction throughout and following adolescence, after at least 1 year wash out of any treatment for precocious puberty. LH, FSH, estradiol, prolactin, androgen secretion, ovarian and breast sonography in luteal and follicular phases of some menstrual cycles were evaluated. We demonstrated the persistence of some ovarian autonomy, documented by hyperestrogenism and/or low or absent gonadotropin secretion and/or ovarian cysts.

An eleven year-old girl presented with right lower quadrant abdominal pain near menarche that coincided with the onset of her most recent menstrual period. A smooth-lined cystic structure with a thick wall was discovered in the right adnexa at surgery that was adherent to a multicystic ovary and a dilated fallopian tube. Histologic examination determined the lesion to be a uterus-like ovarian mass. The patient had a history of a resected right pelvic kidney at four months of age. This case is believed to represent a congenital malformation of the urogenital system rather than smooth muscle metaplasia of ovarian stromal cells.

Study Objective: To evaluate damage to ovarian reserve following laparoscopic cystectomy of benign ovarian cysts., Design: Prospective study (Canadian Task Force classification II-3)., Setting: Tertiary gynecologic endoscopic unit at a university-affiliated hospital., Patients: Thirty-one patients who underwent excision of monolateral (n=25) or bilateral (n=6) benign ovarian cysts., Interventions: Serial transvaginal ultrasound examinations during the first and third postsurgical menstrual cycles. The following ovarian echographic variables were evaluated: antral follicle count, ovarian volume, stromal blood flow, and side of ovulation. Two types of statistical analysis were performed: a paired analysis comparing operated and intact ovaries of the same patient and a prospective analysis comparing ecographic characteristics of the operated gonad at first and second evaluation., Measurements and Main Results: Antral follicle count and stromal blood flow were not significantly affected by surgery. While ovarian volume was similar in the operated and in the contralateral intact gonad at the first ultrasound evaluation, the volume of the operated ovary was significantly reduced at the second assessment. The median (interquartile range) of the percentage of this reduction was 33% (18%-81%). This progressive reduction was confirmed by prospectively analyzing the operated ovaries. An increased probability of ovulation in the intact gonad was observed at both assessments., Conclusion: Laparoscopic excision of ovarian cysts is associated with damage to ovarian reserve, at least immediately after surgery. This effect does not appear to be consequent to an injury to ovarian vascularization.

The authors report on a patient with an uncommon congenital anomaly of bilateral undescended ovaries and tubes. She presented with an acute abdomen at 13 years of age. A computed tomography scan showed a cystic mass suspicious for congenital intestinal duplication. At the time of laparoscopy, she was found to have a bicornuate uterus and bilateral undescended ovaries with a ruptured right hemorrhagic ovarian cyst. This case shows that although a ruptured ovarian cyst can occur in such malpositioned organs, it can pose difficult diagnostic challenges. Suppression of the ovaries with the combined oral contraceptive pill may help to prevent further ovarian cyst development.

Objective: To report a case of virilizing ovarian hilus cell hyperplasia detected postmenopausally in association with a simple cyst and to review the related literature, including four similar cases., Methods: Hormonal and pathologic studies were conducted, and ovarian venous catheterization was performed during total abdominal hysterectomy., Results: In our 69-year-old female patient, serum testosterone levels were 508, >3,200, and 11 ng/dL, respectively, in peripheral blood preoperatively, in ovarian venous blood obtained intraoperatively, and in peripheral blood postoperatively. The wall of the cyst contained several clusters of hilus cells, which were also found asymmetrically lateralized to the affected ovary., Conclusion: Hilus cell hyperplasia should be suspected in any case of postmenopausal virilization in which ultrasonography or magnetic resonance imaging suggests the presence of a simple ovarian cyst.

Vaginal bleeding during the neonatal period is commonly related to the withdrawal of maternal estrogens. Vaginal bleeding has also been reported in female infants with congenital adrenal hyperplasia and has been proposed to be due to a treatment-induced activation of the hypothalamic-pituitary-ovarian axis. We report a female infant with the salt-losing form of congenital adrenal hyperplasia due to 21-hydroxylase deficiency, who had the onset of vaginal bleeding at 3 months of life. Adrenal steroid suppression had been achieved by 2.5 weeks of age. At the time of bleeding, imaging studies revealed an enlarged right ovary with a dominant 3-cm cyst and additional small cysts that had not been seen on the newborn sonogram. The uterus was enlarged and stimulated. Three weeks later (1 week after the cessation of bleeding), repeat ultrasound demonstrated a marked decrease in the size of the right ovary, and the dominant cyst was no longer seen. The patient had a heightened FSH response to GnRH and elevated levels of estradiol for age. At 5 months of age, no further episodes of sustained vaginal bleeding were observed. Repeat hormonal levels were prepubertal, and pelvic sonogram demonstrated no evidence of stimulation. The findings in our patient suggest that a decline in adrenal androgens after glucocorticoid treatment resulted in an increase in gonadotropin levels, which then triggered a transient and augmented end-organ response (menses). Further, we suggest that our infant's hormonal findings may reflect a delay in the timely development of the negative restraint by sex steroids on gonadotropins that is normally observed in infancy.

A 68-year-old woman who had virilization was found to have an androgen-secreting simple ovarian cyst at laparotomy. Histologic examination demonstrated hilus cell hyperplasia in the ovarian hilus and cyst wall. In the differential diagnosis of postmenopausal virilization, hilus cell hyperplasia, although rare, should be considered.

Background: Hormone production is a characteristic associated with the presence of solid tumors in the ovary. We present a case of a solitary ovarian cyst producing large amounts of testosterone and presenting with rapid onset of hirsutism., Case: A woman presented approximately 6 months postpartum with irregular menses and rapid onset of hirsutism. Laboratory and radiologic evaluation indicated an ovarian cyst as the source. On removal, the cyst was found to have high amounts of testosterone in its fluid and the surrounding stroma had nests of luteinized cells., Conclusion: The chronic anovulation in the postpartum period may have prolonged the lifespan of the luteinized stromal cells, resulting in high levels of circulating testosterone and causing rapid progression of hirsutism.

Objective: The purpose of this study was to determine the frequency with which sonographic detection of a normal separate ipsilateral ovary enables the diagnosis of paraovarian cysts., Materials and Methods: We reviewed the initial sonographic reports, sonograms, and medical records of 42 patients with surgically proved paraovarian cysts. All sonograms were obtained with a 3.5-MHz transabdominal probe. The location, size, shape, wall thickness, internal echoes of the cyst, and visualization or nonvisualization of the ipsilateral ovaries were recorded during sonographic examination., Results: Forty-six paraovarian cysts were identified in 42 patients. One patient had bilateral cysts, and one had multiple (four) unilateral cysts. A teratoma in one patient and an ovarian cyst in another coexisted with a paraovarian cyst in the same adnexa. With the exception of these two, 31 (76%) of 41 ovaries abutted by cysts were detected. All detectable ovaries were normal. With one exception, all cysts were thin walled and unilocular, and 43 of 46 were anechoic. During surgery, two patients were found to have cyst torsion, two were found to have papillary serous cystadenoma, and one was found to have both., Conclusion: Unlike the findings of previous reports, our results indicate that most patients with paraovarian cysts have a separate, normal ipsilateral ovary that can be detected easily by means of transabdominal sonography, thus aiding in distinguishing paraovarian from true ovarian cysts.

A female neonate with a streak ovary on one side and huge ovarian cyst on the other side is presented. Her karyotype was 46,XX. Adnexectomy was mandatory, leaving the patient with a single streak gonad. Whether this infant has the recessive form of gonadal dysgenesis with one ovary, streak or hypoplastic, replaced by a cyst or the Slotnick-Goldfarb syndrome is impossible to elucidate at present. The potential implications of a streak gonad, either related to gonadal dysgenesis or as a possible source of neoplasia, are reviewed. Current approaches to an ovarian cyst and streak ovary in the neonatal period are discussed.

A careful physical examination of a cow or heifer suspected of having an ovarian problem often results in a specific diagnosis (e.g., freemartinism) or a workable list of differentials. When the diagnosis is uncertain, techniques such as rapid progesterone assays, ultrasonographic imaging, ova or embryo recovery, and cytogenetic evaluation can provide critical information for a well-based diagnosis and prognosis. Despite the wide array of problems that can afflict the bovine ovary, cystic ovaries probably are the most commonly diagnosed and treated ovarian abnormality. Cysts have a variable life span and sometimes occurs together with a CL. Hormonal therapy with either GnRH followed by PG approximately 9 to 14 days later, or GnRH alone, followed by good heat detection is the treatment of choice for cows with cysts. Other conditions associated with ovarian dyfunction and infertility include adhesions, developmental anomalies, and tumors. The life span of a CL in the cow can be shortened unintentionally by attempting to correct other problems (e.g., multiple injections of oxytocin for milk let-down), or lengthened by uterine pathology (e.g., pyometra, or uterus unicornis). The administration of GnRH or hCG to improve ovarian function and pregnancy rates in cows may be beneficial in selected herds.

A 28-year-old married, Korean woman was diagnosed with a right unicornuate uterus, a left hypoplastic tube, and a right ovarian necrotic corpus luteal cyst. We performed a right oophorectomy and an excision of the left hypoplastic tube and then transferred the left ovary to the right broad ligament with intact vascular pedicles. Thus the remaining left ovary and right fallopian tube were placed in proximity. The patient conceived 2 months after the operation and delivered a living male infant.

We studied 17 girls with the complaint of premature breast development. Enlarged breast tissue was confirmed in 15 patients by sonography. Pelvic and breast sonography were also performed in these patients. The sizes of most uteri and ovaries were within the normal range. Nine of the 15 patients (60%) showed follicular cysts in the ovaries. These cysts were ovoid with diameters of up to 10 mm. No relationship was found between the thickness of breast tissue and the ovarian findings. Pelvic sonography was also performed in normally developing girls under 6 years of age. Four of 47 girls (4%) showed small follicular cysts in the ovaries. In summary a high percentage of patients with premature thelarche have relatively large follicular cysts, with normal sized ovaries and uteri. Breast sonography is useful to distinguish swollen subcutaneous tissue from breast development.

The ovarian hyperstimulation syndrome is the most serious complication following ovulation induction. It is assuming greater clinical importance now that the indication for ovulation induction is no longer limited to anovulatory women but expands to other infertility problems. In its most severe manifestation the ovarian hyperstimulation syndrome consists of massive ovarian enlargement with multiple cysts, hemoconcentration, ascites, and pleural and pericardial effusion. There is no specific treatment and a reduction in the incidence of this iatrogenic syndrome can be achieved only by preventive measures.

Moderate ovarian hyperstimulation syndrome occurred after LA was administered to control menorrhagia in an anephric woman who required hemodialysis. We postulate that women who require dialysis may be at special risk for the development of this syndrome.

Laparoscopically directed ovarian biopsy has been evaluated in 39 cases of secondary amenorrhea. The definite diagnosis was achieved in 29 cases. In 10 cases, ovarian histopathology alone was insufficient, and the estimations of gonadotropins were essential for the final diagnosis. The scope and limitations of this procedure for the differential diagnosis of premature ovarian failure and hypothalamic-pituitary lesions are discussed.

A patient with persistent ovarian cysts subsequent to clomiphene-induced severe hyperstimulation was found to have borderline ovarian carcinoma. Since several endocrine and epidemiological studies implicate hormonal factors in the genesis of ovarian tumors, a possible association between ovarian hyperstimulation and neoplasia is suggested.

Ovarian vascular accidents are usually more severe when the patient is being kept on anticoagulant therapy following cardiac surgery or for other reasons. 4 cases of massive hemoperitoneum are reported. Rupture of the corpus luteum and corpus luteum cyst and an ovarian ectopic pregnancy were responsible for massive hemoperitoneum. All 4 patients survived and recovered.

Wedge resection of the ovary was carried out in 45 anovulatory women to study the correlation between the degree of disturbance of ovulation and the histopathological findings. Polycystic ovary was always found in patients with anovulatory cycles. The ovaries in grade 1 amenorrhea showing withdrawal bleeding in response to gestagen alone belonged to the nonspecific type, polycystic type and sclerotic type. These histological changes were relatively mild in many cases. The ovaries in grade 2 amenorrhea showing withdrawal bleeding in response to estrogen and gestagen but not to gestagen alone belonged to the non-specific type, polycystic type, sclerotic type, atrophic type and streak type. Even within the same histological entity, the histological findings of the ovaries were more pronounced in grade 2 amenorrhea than in grade 1 amenorrhea. The patients with primary amenorrhea had only hypoplastic and aplastic ovaries with marked histological abnormalities.

This study was undertaken to examine ovarian steroid production during the early stages of hCG-induced ovarian cyst formation in the hypothyroid rat. Rats were placed into two groups with one group made hypothyroid by adding thiouracil to their diet. After 10 days, each group was divided into two subgroups with one subgroup receiving daily injections of hCG for 2 days and the other subgroup receiving saline. On the morning of Day 13, ovaries were removed and incubated for 2 hr. No significant difference in progesterone secretion was observed. However, ovaries from hypothyroid, hCG-treated rats secreted significantly more testosterone and estradiol than ovaries from vehicle-treated, hypothyroid rats and euthyroid, hCG-treated rats. In a second experiment, ovaries from euthyroid and hypothyroid rats treated with hCG were incubated in medium supplemented with 100 nM androstenedione and 0 or 100 ng FSH/ml. FSH failed to affect progesterone, testosterone, and estradiol secretions by ovaries from euthyroid, hCG-treated rats. In contrast, FSH significantly enhanced testosterone and estradiol secretion by ovaries from hypothyroid, hCG-treated rats. These results support the hypothesis that increased levels of testosterone and estradiol secretion have a central role in the induction of polycystic ovaries by hCG in the hypothyroid rat.