A biotin-streptavidin enzyme immunoassay for detection of antibodies to porcine granulosa cell antigens

Premature ovarian "failure" in the adolescent

Premature ovarian "failure" (POF) is an enigmatic and heterogeneous disorder characterized by amenorrhea, hypoestrogenism, and hypergonadotropinism that occurs in women under the age of 40 years. The predominant causes are different in the adolescent, and more of these causes are associated with permanent cessation of ovarian function. It would seem that the more common causes of POF in adolescents include cytogenetic abnormalities involving the X chromosome, ovarian dysfunction occurring in association with other autoimmune endocrine disturbances, and chemotherapy and/or radiation therapy given for any of a number of malignancies. Special challenges in the adolescent beyond establishing the diagnosis include counseling the young woman and her family and discussing the possibility of future pregnancy. Lifelong therapy must be addressed as well. Any discussion of POF raises numerous unanswered questions that should be the focus of future research.

Premature ovarian failure: an update

OBJECTIVE

To present an overview of potential etiologies, clinical manifestations, and treatment modalities of premature ovarian failure (POF).

DESIGN

A search of past and current articles on basic ovarian physiology and POF with use of MEDLINE. Additional information was obtained from an active study section on POF at the National Institutes of Health. Specific sections of this manuscript summarize the strengths and weaknesses of the possible pathophysiologic processes and management options of POF as they appear in the literature.

RESULT(S)

POF is not an uncommon disorder. Although the etiology remains elusive in most cases, several rare specific causes have been discovered. Although POF was once thought to be permanent, a substantial number of patients experience spontaneous remissions. Because of the association with other autoimmune diseases, close follow-up is recommended in patients with POF. Hormone replacement therapy remains the cornerstone of treatment, and the best chance of achieving a pregnancy is through oocyte donation.

CONCLUSION(S)

An understanding of basic ovarian embryology and physiology will allow clinicians to apply current treatments and develop new innovative therapies for their patients with POF.