The prevalence of autoimmune disorders among patients with primary ovarian failure.

Eighty-one patients who had a diagnosis of primary ovarian failure were studied to determine its possible association with autoimmune disorders. All 81 patients displayed 46,XX chromosome complements. On ovarian biopsy, either few or no follicles were demonstrated in 79 patients, and, in two patients, primordial follicles were more abundant. The two patients with a large number of primordial follicles had normal function of other endocrine organs; however, 15 of the 79 patients demonstrating few or no ovarian follicles had associated failure of other endocrine glands, and one patient had myasthenia gravis. Thirteen of these 15 patients sought treatment because of secondary amenorrhea, the age at onset ranging from 11 to 34 years. Of the 81 patients, 11 had primary amenorrhea and 70 had secondary amenorrhea. Among the 79 patients with few or no ovarian follicles, endocrine glandular failure, in addition to ovarian failure, was found in two patients with primary amenorrhea and in 13 patients with secondary amenorrhea. The association of polyglandular failure syndrome and primary ovarian failure, along with demonstration of a lymphocytic infiltrate in ovaries and circulating antibodies in sera of women with premature ovarian failure, suggests that an autoimmune mechanism may be a cause of primary ovarian failure in some cases.