Ovarian Manifestations in Women with Autosomal Dominant Polycystic Kidney Disease

Background: Ovarian cysts are found in some premenopausal women with autosomal dominant polycystic kidney disease (ADPKD). Liver cysts are the major extrarenal manifestations, frequently found in postmenopausal women. Female steroid hormones may regulate hepatic cystogenesis, but ovarian manifestations in postmenopausal women are unknown. The aim of the present study is to investigate possible ovarian manifestations associated with ADPKD in premenopausal and postmenopausal women.

Methods: The study group included 19 premenopausal or postmenopausal women with ADPKD and 19 age- and parity-matched control women with no history of renal disease. Ovarian structures and volumes were measured by means of transvaginal ultrasonography.

Results: Three of 8 premenopausal and 1 of 11 postmenopausal women with ADPKD had a small unilateral single ovarian cyst; there were none in controls. Eight women with ADPKD and 8 controls of premenopausal age had similar ovarian volumes (4.92 +/- 2.97 versus 3.92 +/- 2.60 cm3). Eleven postmenopausal women with ADPKD had an increased mean ovarian volume compared with 11 postmenopausal controls (4.11 +/- 2.60 versus 1.66 +/- 0.96 cm3; P < 0.01). Ovarian volume was not associated with the use of hormonal replacement therapy or impaired renal function in postmenopausal women with ADPKD.

Conclusion: ADPKD is not associated with cystic ovaries, although single ovarian cysts are occasionally found. Equal ovarian volumes between premenopausal and postmenopausal women with ADPKD suggest a possible indirect effect of polycystic kidneys on gonads in aging women.