Ovarian Diseases

During pregnancy, it is possible for the tissue surrounding the embryo to degenerate. Such degeneration typically manifests itself in hydatidiform moles and choriocarcinoma. These tumors are difficult to diagnose and are associated with an increased level of beta hCG. Treatment involves the complete removal of the tumorous growth. The characteristics of the tumors are described in more detail below.

Ovarian cancer is becoming challenging every year due to the ever increasing number of new diagnoses. It is considered the 5th leading cause of cancer deaths among women; with about 14,000 deaths and more than 20,000 new cases every year.

Ovarian cancer is of epithelial origin in 60% of the patients. Most patients present at an advanced stage due to the lack of specific symptoms except for mucinous ovarian cancer where abdominal distension is so severe that patients present very early in the disease. Once ovarian cancer is suspected, the patient usually undergoes a transvaginal ultrasonography, abdomen-pelvic CT scan and CA-125 concentration measurement. If an ovarian cyst or mass is identified, its characteristics will be noted and a risk of malignancy index can be calculated. Treatment involves neoadjuvant platinum-based chemotherapy with or without surgery. Newer treatments include antiangiogenic antivascular endothelial growth factor bevacizumab and pazopanib.

Polycystic ovary syndrome or disease is a multisystem endocrinological disorder where there is hyperandrogenism, ovarian dysfunction, obesity, menstrual abnormalities and multiple ovarian cysts. The most common presenting features are hirsutism, acne, metabolic syndrome and biochemical hyperandrogenism. Patients also have hyperlipidemia and an impaired glucose metabolism. Treatment involves oral contraceptive pills for menstrual abnormalities and hyperandrogenism, metformin for hyperandrogenism and infertility and clomiphene for infertility. Infertile women who do not respond to clomiphene might benefit from gonadotropins or laparoscopic ovarian drilling (LOD).