Lawrence M Nelson1, Sharon N Covington, Robert W Rebar. 1. Intramural Research Program, Section on Women's Health Research, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA. Lawerence_Nelson@nih.gov
Abstract
OBJECTIVE: To update clinicians regarding the management of women with spontaneous premature ovarian failure (POF). DESIGN: Literature review and consensus building among three clinicians with experience in caring for women with spontaneous POF. CONCLUSION(S): Clearly the ovarian "failure" in this disorder is not permanent in all women. Approximately 5%-10% may conceive spontaneously and unexpectedly after the diagnosis. An integrated approach to management is best, and there is a need to first address physical and mental health issues before addressing plans for family building. Women with spontaneous POF are at increased risk of adrenal insufficiency, which should be detected and managed appropriately, especially before proceeding to ovum or embryo donation procedures. Young women with POF experience pathologically low serum E2 levels at least intermittently. Despite the absence of controlled evidence for this specific population, physiologic replacement of ovarian steroid hormones seems rational until the age of normal menopause. The disorder may be associated with other conditions that require evaluation and management, including hypothyroidism, dry eye syndrome, abnormal karyotype, or a premutation of the FMR1 gene. Finally, clinicians need to be sensitive to the emotional aspects of this disorder when delivering the diagnosis and during subsequent management.
OBJECTIVE: To update clinicians regarding the management of women with spontaneous premature ovarian failure (POF). DESIGN: Literature review and consensus building among three clinicians with experience in caring for women with spontaneous POF. CONCLUSION(S): Clearly the ovarian "failure" in this disorder is not permanent in all women. Approximately 5%-10% may conceive spontaneously and unexpectedly after the diagnosis. An integrated approach to management is best, and there is a need to first address physical and mental health issues before addressing plans for family building. Women with spontaneous POF are at increased risk of adrenal insufficiency, which should be detected and managed appropriately, especially before proceeding to ovum or embryo donation procedures. Young women with POF experience pathologically low serum E2 levels at least intermittently. Despite the absence of controlled evidence for this specific population, physiologic replacement of ovarian steroid hormones seems rational until the age of normal menopause. The disorder may be associated with other conditions that require evaluation and management, including hypothyroidism, dry eye syndrome, abnormal karyotype, or a premutation of the FMR1 gene. Finally, clinicians need to be sensitive to the emotional aspects of this disorder when delivering the diagnosis and during subsequent management.
Authors: Joyce Y Tung; Mitchell P Rosen; Lawrence M Nelson; Paul J Turek; John S Witte; Daniel W Cramer; Marcelle I Cedars; Renee A Reijo Pera Journal: Hum Genet Date: 2005-11-22 Impact factor: 4.132
Authors: Peter J Schmidt; Jamie A Luff; Nazli A Haq; Vien H Vanderhoof; Deloris E Koziol; Karim A Calis; David R Rubinow; Lawrence M Nelson Journal: J Clin Endocrinol Metab Date: 2010-11-03 Impact factor: 5.958
Authors: Susan A Orshan; June L Ventura; Sharon N Covington; Vien H Vanderhoof; James F Troendle; Lawrence M Nelson Journal: Fertil Steril Date: 2008-10-01 Impact factor: 7.329
Authors: Sophia N Kalantaridou; Vien H Vanderhoof; Karim A Calis; Emily C Corrigan; James F Troendle; Lawrence M Nelson Journal: Fertil Steril Date: 2007-10-25 Impact factor: 7.329