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Artefactual loss of human ovarian surface epithelium: potential clinical significance.

To investigate whether the human ovarian surface has an intact epithelial layer, 69 ovarian biopsies from 39 women were taken. When the surface was touched or wiped, there was a widespread loss of cells that were otherwise retained in surface depressions or crypts. By avoiding contact with the surface, the layer was retained. A temporary disruption to the surface following ovulation was followed by complete healing and re-epithelialization. These observations suggest that previous studies describing the loss of surface epithelium may have artifactually generated this loss, possibly by handling the surface during surgical retrieval. The possible clinical significance of these observations is that inadvertent ovarian handling during any ovarian surgery may be implicated in the pathogenesis of adhesion formation, simply by removing the surface that is important in tissue repair.