Premature ovarian failure

Abstract

Forty women with premature ovarian failure (POF) arising post-puberty (PPOF) during the reproductive lifespan, underwent karyotyping, pelvic ultrasonography, hormonal assays, hematochemical and immunological examinations. In 52.5%, PPOF was idiopathic, while in 45% the cause was immunological and in 2.5% chromosomal. The hormonal parameters were characterized by elevated plasma levels of gonadotropins (especially follicle-stimulating hormone, FSH), insulin and thyroid-stimulating hormone (TSH) and low levels of 17 beta-estradiol, prolactin, androstenedione, testosterone and dehydroepiandrosterone sulfate. One or more autoantibodies were present in 18 subjects (45%). Among the antibodies, the most representative were: antithyroid microsomal (27.5%), antinuclear antibody (20%) and antithyroid globulin (12.5%). Ultrasound showed that the ovaries were of normal volume (3.1 +/- 0.3 cm3) in 14 women (35%) and significantly smaller (1.4 +/- 0.4 cm3) in 26 (65%). Follicles were present in 10 women (25%). In patients with autoantibodies, ovaries were of small volume (n = 15, 83.3%) and had follicles (n = 6, 33.3%) in a significantly greater percentage compared to those without autoimmune etiology (n = 11, 50%; n = 4, 18.2%, respectively). Women with PPOF, all having secondary amenorrhea, presented significantly higher levels of total cholesterol, and low-density lipoproteins and lower levels of high-density lipoproteins.