OVARIES IN SEXUAL PRECOCITY

BACKGROUND AND OBJECTIVE Ovarian ultrasonography may be helpful in dis tinguishing the various types of precocious puberty, and the ovarian a ppearances increasingly influence choice of therapy in these girls. We examined retrospectively the ovarian volume and prevalence of polycys tic ovarian appearance at ultrasound in girls with sexual precocity. D ESIGN Ultrasound examinations were obtained from girls who presented w ith sexual precocity. If there were several scans from the same indivi dual, the latest was analysed. PATIENTS The girls were divided into gr oups: untreated central precocious puberty (n = 25), central precociou s puberty treated with GnRH analogue (n = 18) or with GnRH analogue an d recombinant human GH (n = 11), girls who had stopped treatment with GnRH analogue and GH (n = 12), premature thelarche and thelarche varia nt (n = 15) and premature adrenarche (n = 14). MEASUREMENTS Ovarian vo lume was calculated and the ovaries were assessed for polycystic appea rance using standard criteria. Ovarian volume standard deviation (SD) scores were calculated using means and standard deviations derived fro m a control population and compared using analysis of variance. Differ ences from control data were assessed using Student's t-test. RESULTS Ovarian volume SD scores for all the groups studied were greater than those for control subjects. Girls who had stopped treatment with GnRH analogue and GH had mean ovarian volume of 6.98 ml and ovarian volume SD score (+1.72) greater than that of girls having treatment with GnRH analogue alone (+1.24). Polycystic appearance ovaries were found in 8 3% of scans in girls who had stopped treatment with GnRH analogue and GH. The ovarian volume SD score of girls with premature adrenarche was less than that of girls with untreated central precocious puberty. CO NCLUSIONS Girls with central precocious puberty had large ovaries whic h did not return to a volume appropriate for age. Girls treated with G nRH analogue and GH developed very large ovaries when they stopped tre atment, and had an increased prevalence of ovaries with a polycystic a ppearance. Central precocious puberty, or some aspect of its treatment , results in an increased prevalence of polycystic ovarian appearance.