Premature ovarian failure: etiology and possible prevention

Abstract

Premature ovarian failure (POF) is defined as premature menopause in women younger than 40 years of age. This heterogeneous disorder (occurring in 1% of women younger than 40 of age and 0.1% of those younger than 30 years of age), is associated with many and different etiologies, such as chromosomal, genetic, enzymatic, iatrogenic, metabolic and infectious causes. Only in less than half of cases can the etiologic cause be identified. In the last decade, many genetic abnormalities were identified in association with POF, mainly owing to the transgenic mice models, which enabled the study of phenotype in these null mice. Iatrogenic POF after chemotherapy has gained worldwide interest owing to significantly improved survival in the last three decades and the ability to preserve future fertility and ovarian function in many young women who are survivors of young-age malignancy. The attempts of in vitro fertilization-assisted reproductive technology and embryo or unfertilized ova cryopreservation, combined with ovarian tissue cryopreservation and coadministration of gonadotrophin-releasing hormone agonists in parallel with chemotherapy may maximize future fertility and minimize long-term POF in these women.

Keywords::

• fragile X
• genetic determinant
• gonadotoxicity
• gonadotrophin-releasing hormone agonist
• hypergonadotropic amenorrhea
• premature ovarian failure

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.