Prevalence of autoimmune disease in women with premature ovarian failure

Abstract

Objective: The aim of the study was to investigate the relationship between premature ovarian failure and autoimmune disease.

Methods: This interdisciplinary prospective study included 52 consecutively recruited women with premature ovarian failure, aged 18–40 years. Diagnosis of premature ovarian failure was defined as amenorrhoea lasting more than 4 months and anti-Müllerian hormone levels below the age-appropriate range. Women with an abnormal karyotype or Fragile X syndrome were excluded from the study. All participants were screened by a rheumatologist for the presence of underlying autoimmune disease.

Results: The average age at first diagnosis of premature ovarian failure was 29.5 years; 92.3% of participants (n = 48) presented with a secondary amenorrhoea, while only 7.7% (n = 4) had primary amenorrhoea. Of all 52 participants, 40.4% (n = 21) had at least one confirmed autoimmune disease, including Hashimoto’s disease, systemic lupus erythematosus, rheumatoid arthritis, psoriasis, Crohn’s disease, polyglandular autoimmune syndrome and coeliac disease. Response rates for hormonal stimulation therapy were low and the presence of autoimmune disease was associated with poor infertility treatment outcome.

Conclusions: We found a high prevalence of autoimmune disease in women with premature ovarian failure. Screening for autoimmune diseases should be offered to all women with premature ovarian failure.

摘要

目的：本研究的目的旨在研究卵巢早衰和自身免疫性疾病之间的关系。

方法：该跨学科的前瞻性研究纳入了连续招募的18至40岁卵巢早衰女性52名。卵巢早衰的诊断定为闭经4个月以上且抗穆勒氏管激素水平低于其适宜年龄范围。核型异常或者脆性X综合征的女性不纳入研究。所有的研究对象都经过风湿病学家的筛选, 以确定是否存在潜在的自身免疫性疾病。

结果：初次诊断卵巢早衰的平均年龄是29.5岁。92.3%的研究对象（n=48）出现了继发性闭经, 仅有7.7%（n=4）是原发性闭经。52名研究对象中, 40.4%（n=21）至少患有一种自身免疫性疾病, 包括桥本甲状腺肿、系统性红斑狼疮、类风湿关节炎、银屑病、克罗恩病、多内分泌腺自身免疫综合征和乳糜泻。激素刺激治疗的有效率低, 患有自身免疫性疾病与不孕治疗效果差相关。

结论：我们发现卵巢早衰的女性自身免疫性疾病的患病率高。所有卵巢早衰的女性都应进行自身免疫性疾病的筛查。

Keywords:

• Adrenal disorders
• autoimmune disease
• female infertility
• reproductive immunology
• thyroid disorder

Disclosure statement

No potential conflict of interest was reported by the authors.