Premature ovarian failure

B. Runnebaum, T. Rabe
In: Reproduktionsmedizin · 1999 · vol. 15(5) , pp. 343–347 · doi:10.1007/s004440050124 · W2059652338
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Premature ovarian failure affects 1% of fertile women with heterogeneous, often unknown causes, requiring FSH monitoring, exclusion of other diseases, hormone replacement therapy, and offering an unfavorable pregnancy prognosis.

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This paper reviews premature ovarian failure (about 1% prevalence in women of reproductive age), focusing on its heterogeneous and often unknown etiology and on diagnostic approaches using patient history and repeatedly elevated serum FSH levels (>40 IU/L). It notes that associated conditions such as autoimmune disease and galactosemia should be excluded with additional targeted diagnostics. The review reports that fertility could not be improved by suppressing FSH with GnRH analogues or danazol followed by high-dose gonadotropin stimulation, including when preceded by estrogen pretreatment. It concludes that pregnancy prognosis is poor and unpredictable, and that long-term hormone replacement therapy is required, noting that under a biphasic HRT regimen spontaneous pregnancy is not excluded. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Zusammenfassung Die Prävalenz der vorzeitigen Ovarialinsuffizienz (VO) betraegt 1 % bei Frauen im fertilen Alter. Die Ätiologie dieser Erkrankung ist heterogen und lässt sich häufig nicht klären. Für die Diagnostik sind Anamnese und FSH-Bestimmungen (wiederholte Bestimmungen über 40 IE/l) entscheidend. Wegen möglicher Begleiterkrankungen, wie eine Autoimmunerkrankung bzw. eine Galaktosämie ist eine zusätzliche spezielle Diagnostik ratsam. Eine Verbesserung der Fertilität konnte durch Therapien zur Suppression der FSH-Konzentration mit GnRH-Analoga oder Danazol und anschliessender hochdosierter Gonadotropinstimulation nicht erreicht werden, auch nicht durch Vorbehandlungen mit Östrogenen. Die Prognose hinsichtlich einer Schwangerschaft ist bei VO sehr ungünstig und im Einzelfall nicht vorhersehbar. Unbedingt notwendig ist eine Hormonersatztherapie, die in Hinsicht auf die Gesundheit der Frau langfristig durchgeführt werden sollte. Unter einer biphasischen Hormonersatztherapie ist eine Schwangerschaft nicht ausgeschlossen. Summary The prevalence of a premature ovarian failure (POF) is about 1 % of all fertile women. The etiology of the disease is heterogenic and in most cases unknown. Patients history and determination of serum FSH (continously above 40 IE/l) is important. Concomitant diseases such as autoimmune diseases or a galactosemia must be excluded. Fertility cannot be improved by suppression of serum FSH by means of GnRH-analogues or Danazol followed by a high dose stimulation with gonadotropins or a pretreatment with estrogens. The prognosis in view to a pregnancy is unfavourable and in the individual case not predictable. A long term hormone replacement therapy is absolutely required in view to the health of the women with POF. In patients treated with biphasic HRT regimen a spontanous pregnancy cannot be excluded. Similar content being viewed by others Author information Authors and Affiliations Rights and permissions About this article Cite this article Runnebaum, B., Rabe, T. Premature ovarian failure. Reproduktionsmedizin 15, 343–347 (1999). https://doi.org/10.1007/s004440050124 Published: Issue date: DOI: https://doi.org/10.1007/s004440050124

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