In 48 patients with L / M-transsexualism, an ultrasound examination (ultrasound) of the pelvic organs was performed prior to the initiation of androgen testing. Small-cystic changes in ovarian tissue were found in 16 (25%) patients. All patients were prescribed androgen therapy (Sustanon-250, Omnadren-250) in a dose of 1 ml for 3-5 weeks. (the mode of injections was selected individually, depending on the rate of decrease in the level of testosterone in the blood plasma). A year after the onset of androgen therapy in all 48 patients, small cystic changes in ovarian tissue were detected with repeated ultrasound of the pelvic organs (androgen levels in the blood plasma in all patients a year after the onset of androgen therapy corresponded to those characteristic of healthy men, and amounted to 13-33 mmol / l ). In the same period, on the background of androgenotherapy, 3 patients underwent histological examination of the ovaries removed during the surgical phase of treatment. During the histological examination of the distant ovaries, we found in the cortical layer single primordial follicles with signs of degeneration (in 1 patient) or the absence of primordial follicles (in 2 patients). All patients had cystic-degenerated abdominal follicles with a diameter of 5.5 mm.
The main cause of folliculogenesis suppression in patients with G / M transsexualism with an initially normal ultrasound ovarian tissue pattern (in our observation, 32 out of 48 patients) is prolonged exposure to Androgen, since all patients received a prolonged androgenic drug for a year.
To clarify the reasons for the initial, prior to androgen therapy, small cystic degeneration of ovarian tissue, which according to the ultrasound picture was found in 16 patients with F / M transsexualism, further study and accumulation of facts is necessary. Considering also the presence of elevated testosterone levels in the blood plasma of patients with G / M-transsexualism before the start of androgen therapy, the presence of PCOS cannot be ruled out in these 16 patients. Our data on the high association of LC / M-transsexualism and PCOS (polycystic ovary syndrome) correspond to the data of other authors, according to which PCOS occurs in patients with LC / M-transsexualism in 30% of cases, while the prevalence of this syndrome among women of childbearing age is According to W. Futterweit (1986), only 5%.