Twin pregnancy in premature ovarian failure after estrogen treatment: a case report

Molecular regulation of telomerase activity in aging

The process of aging is mitigated by the maintenance and repair of chromosome ends (telomeres), resulting in extended lifespan. This review examines the molecular mechanisms underlying the actions and regulation of the enzyme telomerase reverse transcriptase (TERT), which functions as the primary mechanism of telomere maintenance and regulates cellular life expectancy. Underpinning increased cell proliferation, telomerase is also a key factor in facilitating cancer cell immortalization. The review focuses on aspects of hormonal regulations of telomerase, and the intracellular pathways that converge to regulate telomerase activity with an emphasis on molecular interactions at protein and gene levels. In addition, the basic structure and function of two key telomerase enzyme components-the catalytic subunit TERT and the template RNA (TERC) are discussed briefly.

Intermittent ovarian and thyroid failure and spontaneous twin pregnancy

Intermittent failure of two endocrine systems is unusual and presents diagnostic and management challenges. We report a case of a young woman with intermittent thyroid and ovarian failure who had spontaneous twin gestation four years after the diagnosis of premature ovarian failure was made. This case demonstrates coincidental biochemical and clinical thyroid and ovarian failure both of which spontaneously resolved with no treatment, although subsequently irreversible hypothyroidism ensued after the initial recovery. Elevated gonadotrophins with a menopausal pattern on more than one occasion, in an amenorrhoeic patient with menopausal symptoms, usually indicates permanent ovarian failure. This case demonstrates that this may not be true and while this is probably a rare occurrence, clinicians need to be aware of this possibility. It also re-emphasizes the need to consider the clinical picture when interpreting biochemical results.

Management of transient ovarian failure: pregnancy after in vitro fertilization and intracytoplasmic sperm injection--a case report

PURPOSE

The case history of a 36-year-old patient with transient ovarian failure, presumably induced by previous ovarian surgery and a recent pelvic inflammatory disease, is described.

METHODS

During several months, the patient underwent transvaginal ultrasound and hormonal follow-up. Ovulation was triggered by hCG in a cycle in which spontaneous follicular ripening had occurred. Transvaginal puncture of the single follicle was performed for in vitro fertilization.

RESULTS

One oocyte was retrieved and fertilized by intracytoplasmic sperm injection, giving rise to a single good-quality embryo. A singleton pregnancy, which ended in the birth of a healthy daughter, was established.

CONCLUSIONS

This case demonstrates that it is worthwhile to monitor patients with transient ovarian failure closely, and if other infertility factors are present, IVF of one oocyte may be considered.