Lifestyle Factors Study
Condition: Reproductive Age; Oophorectomy for Benign Indications
Study type: Observational

Summary: 
      The goals of this research proposal are to further our understanding of the reproductive
      aging process in women and to improve our ability to clinically assess and model reproductive
      aging. Reproductive aging is a continuous process that begins many years prior to menopause.
      Women in their late 30s and early 40s usually maintain normal menstrual function and
      ovulatory status, yet fertility in these women is considerably compromised compared to
      younger women. The primary mechanism of reproductive aging is through the process of ovarian
      primordial follicle (egg) depletion, a process that exhibits considerable variation between
      women. As a result, the age at which an individual begins to experience infertility and
      menstrual cycle changes secondary to follicle depletion also varies significantly and is
      difficult to predict. Multiple studies have investigated the impact of lifestyle choices
      (tobacco use, oral contraceptives, BMI, alcohol use, and parity) on reproductive lifespan by
      correlating the impact of these exposures with the age of spontaneous menopause. Although
      occasionally in agreement, many of these studies report contradictory findings. Alcohol use
      either delays or has no effect upon the age of spontaneous menopause. Similarly, oral
      contraceptive pill use has been suggested to both accelerate and delay the onset of
      menopause. The most consistent findings regarding the impact of these factors is an
      acceleration in the age of menopause by 1-2 years in smokers. Given the lack of consistent
      findings in these investigations, the exact impact of lifestyle factors on reproductive age
      is currently unknown. Nevertheless, the magnitude of such exposures in the U.S. population is
      considerable, with 19% of adult women using oral contraceptives and 19.2% current smokers
      according to recent statistics. This proposal seeks to develop better models of normal female
      reproductive aging through anatomical studies investigating the impact of lifestyle choices
      on ovarian primordial follicle number. A secondary aim is to determine the relationship
      between newly described markers developed to assess biological aging in other organ systems
      (white blood cell telomere length and the measurement of advanced glycation end products
      (AGEs) through skin autofluorescence) and reproductive age.
    

Detailed description: 
      In order to test the hypotheses, we will obtain whole ovaries (single or pairs) from 65
      healthy females between the ages of 21 and 55 undergoing surgical oophorectomy at OU Medical
      Center for benign indications.

        -  informed consent

        -  collection of baseline demographic data (height, weight, ethnicity, age)

        -  completion of structured interview to obtain information regarding oral contraceptive,
           ethanol, tobacco use and socioeconomic status

        -  Measurements of FSH, estradiol, inhibin B, AMH, white-blood cells for telomere length,
           measurement of hemoglobin A1C to control for blood glucose levels

        -  AFC as determined by transvaginal ultrasound exam

        -  skin autofluorescence measurement

        -  subjects then undergo surgery with their primary care gynecologist

        -  determination of ovarian PF number by modern morphometric methods
    

Intervention name(s): Women undergoing a bilateral or unilateral oophorectomy at OU Medical Center, Oklahoma City, Oklahoma
Intervention type(s): Other
Intervention description(s): Women undergoing an elective bilateral or unilateral oophorectomy at OU Medical Center, Oklahoma City, Oklahoma Age range 21-55 years old
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        We will obtain whole ovaries (single or pairs) from 65 healthy females between the ages of
        21 and 55 undergoing surgical oophorectomy for benign indications at the OU Medical Center,
        Oklahoma City, Oklahoma.

        *NOTE: Must be willing to travel to Oklahoma City to participate. Need to have the
        transvaginal ultrasound and skin autofluorescence measurement at the OU Physicians
        Reproductive Health Clinic in Oklahoma City, Oklahoma.
      
Biospecimen description: 
      Telomere length assay
    
Keywords: Ovaries; Reproductive Age; Oophorectomy