Primary ovarian insufficiency

• Published in: The Lancet (British edition) Vol. 376; no. 9744; pp. 911 - 921
• Main Authors: De Vos, Michel, Prof, Devroey, Paul, Prof, Fauser, Bart CJM, Prof
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 11.09.2010; Elsevier; Elsevier Limited
• Subjects: Age; Animals; Antineoplastic Agents - adverse effects; Biological and medical sciences; Bone density; Cancer; Cancer therapies; Disease Models, Animal; Estradiol - blood; Estrogen Replacement Therapy; Female; Fertility; Follicle Stimulating Hormone - blood; General aspects; Health risk assessment; Humans; Infertility, Female - etiology; Internal Medicine; Medical sciences; Menopause; Mortality; Primary Ovarian Insufficiency - chemically induced; Primary Ovarian Insufficiency - diagnosis; Primary Ovarian Insufficiency - etiology; Primary Ovarian Insufficiency - physiopathology; Primary Ovarian Insufficiency - psychology; Primary Ovarian Insufficiency - therapy; Reproduction; Reproductive health; Reproductive Medicine; Risk Assessment; Risk Factors; Sexual health; Womens health; Endocrinopathy; Medicine; Ovarian diseases; Ovarian failure; Primary; Female genital diseases
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(10)60355-8

Summary Primary ovarian insufficiency is a subclass of ovarian dysfunction in which the cause is within the ovary. In most cases, an unknown mechanism leads to premature exhaustion of the resting pool of primordial follicles. Primary ovarian insufficiency might also result from genetic defects, chemotherapy, radiotherapy, or surgery. The main symptom is absence of regular menstrual cycles, and the diagnosis is confirmed by detection of raised follicle-stimulating hormone and declined oestradiol concentrations in the serum, suggesting a primary ovarian defect. The disorder usually leads to sterility, and has a large effect on reproductive health when it arises at a young age. Fertility-preservation options can be offered to some patients with cancer and those at risk of early menopause, such as those with familial cases of primary ovarian insufficiency. Long-term deprivation of oestrogen has serious implications for female health in general; and for bone density, cardiovascular and neurological systems, wellbeing, and sexual health in particular.