Ultasonic assessment of ovarian morphology during lactation & effect of these changes on fertility control
Kerbala Journal of Medicine,
Volume 5, Issue 12, Pages 1420-1429
bjective : The aim of this study was to show the effects of lactation on ovarian morphology by ultrasound examination and to express these effects by terms of fertility control .
Material and Methods: This study was carried in Al-Zahra’a Teaching Hospital Of Maternity & Pediatrics in Al-Najaf City , from March 2007 to September 2007 . A total 100 women were studded , divided into two groups, 50 lactating women and 50 non-lactating women and, a comparison was done between ultrasound findings of the ovaries of the two groups ; those patients were selected from patients attending out patients clinic of Obstetrics & Gynecology unite. History was taken about age , parity , mode of delivery , no. of breast feeding per day , whether the patient use supplementary food or not , no. of feeding at night ,on wishes or demands , if women resume menstruation or not and duration after birth .Ultrasound examination of ovaries was done to all cases and mean ovarian volume , mean follicular number and size was taken and any morphological finding in terms of texture or stromal size
.Results: We found that there is significant effect of lactation on ovarian volume and morphology and increase number of follicles , with peripheral distribution without detection of mature follicle by studying the size of follicle with increase in ovarian stroma ( stromal hyperplasia ).Our study show also that there is strong relationship between suckling episodes , feeding at night , supplementary foodduringbreastfeeding , resumption of menses and age of infant with these effects . So we found that increasing of suckling episodes ( > 8 times of feeding per day ) and feeding at night twice or more , exclusive breastfeeding without giving even water to the baby , with no resumption of menses and infant less than 6 months of age ; all these gives typical effects on ovarian morphology and make the women sub-fertile by ( 76 % ) .
Conclusions: We conclude that lactation can be considered as fertility control method as long as they may mimic polycystic ovarian syndrome by morphological changes of the ovaries which are temporary as far as these above criteria met by the lactating mother.
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