Intermittent Ovarian Activity May Follow Premature Ovarian Failure
5 December 2011
Premature Ovarian Failure affects about 1% of women under the age of 40. Previous studies have shown that 11% to 40% of women with POF may experience intermittent ovulation and 3% to 10% may conceive spontaneously after diagnosis.
However a recent study from French researchers in the Journal of Clinical Endocrinology & Metabolism suggests that around a quarter of women with idiopathic POF may resume ovarian function intermittently.
Dr. Touraine and colleagues from Groupe Hospitalier Pitie-Salpetriere in Paris used data on 369 women with idiopathic (having no identifiable cause) POF to identify predictive factors for return of ovarian function based on initial screening results.
During a mean follow-up of 59 months, 86 women (24%) experienced intermittent ovarian function. Seventy-eight of these women resumed their menstrual cycles and 15 of them experienced spontaneous pregnancies resulting in 16 live births, 1 twin birth, 4 miscarriages, and 1 elective abortion. The pregnancies occurred between 1 and 69 months after POF diagnosis.
The factors which were studied included familial history of POF, secondary amenorrhea (periods stopping after having been present and hence having had some time of normal ovarian function), follicles observed at ultrasound, and inhibin B and estradiol levels.
Based on this model, women with the lowest score (<0.23) had essentially no return of ovarian function at 48 months, compared with 83.3% of women with the highest score (3.87 and higher).
Among clinical predictive factors, primary or secondary amenorrhea appears to be a critical factor. Only 2 patients with primary amenorrhea (having never had periods) showed resumption of ovarian activity, and both had signs of a diagnosis other than POF.
Although of great interest, it does not seem that the model can be used at this time to predict which women with POF will become pregnant since such study was impossible due to the low number of spontaneous pregnancies among this group of patients.
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