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Wiltshire A, Ghidei L, Dawkins J, Phillips K, Licciardi F, Keefe D. Primary ovarian insufficiency: a glimpse into the racial and socioeconomic disparities found within third-party reproduction. F S Rep 2022; 3:62-65. [PMID: 35937445 PMCID: PMC9349244 DOI: 10.1016/j.xfre.2021.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To describe a unique case of primary ovarian insufficiency and review the systemic barriers in place that hinder reproductive autonomy for Black women who require third-party reproduction. Design Case report and review of the literature. Setting Safety-net hospital in an urban community. Patient(s) A 36-year-old Black woman, gravida 0, with primary ovarian insufficiency who desires future fertility but is restricted by systemic barriers. Intervention(s) Chromosome analysis. Main Outcome Measure(s) Not applicable. Result(s) Balanced reciprocal translocation between chromosomes 1 and 13: 46,XX,t(1;13)(q25;q14.1). Conclusion(s) The field of assisted reproductive technology has evolved at an exponential rate, yet it unfortunately benefits some and not all. It is imperative that when we advocate for full spectrum infertility care, that this encompasses everyone. As we continue to further study and develop assisted reproductive technology, we must not forget to consider the factors leading to racial and socioeconomic disparities in reproductive care access, utilization, and outcomes.
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Affiliation(s)
- Ashley Wiltshire
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, New York University Langone Fertility Center, New York City, New York
- Reprint requests: Ashley Wiltshire, M.D., Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, New York University Langone Fertility Center, 660 1st Ave, New York City, New York 10016.
| | - Luwam Ghidei
- Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, Houston, Texas
| | - Josette Dawkins
- Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, Texas
| | - Kiwita Phillips
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia
| | - Frederick Licciardi
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, New York University Langone Fertility Center, New York City, New York
| | - David Keefe
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, New York University Langone Fertility Center, New York City, New York
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Chen B, Li L, Wang J, Zhou Y, Zhu J, Li T, Pan H, Liu B, Cao Y, Wang B. Identification of the first homozygous POLG mutation causing non-syndromic ovarian dysfunction. Climacteric 2018; 21:467-471. [PMID: 29992832 DOI: 10.1080/13697137.2018.1467891] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To investigate the genetic cause of non-syndromic ovarian dysfunction in a patient from a consanguineous family. METHODS This study examined a patient with irregular menstrual cycles and abnormal oocytes. The patient had undergone irregular hormone replacement therapy over 3 years to adjust the menstrual cycle and improve ovarian function. Prior to ovarian stimulation in our hospital, 3 months of androgen and regular hormone therapy were used as an intervention method. No follicular development was detected in the subsequent three cycles using letrozole treatment. The patient then received a constantly adjusted dose of menotropins, but produced only one oocyte. RESULTS Whole-exome sequencing analysis identified the first homozygous POLG mutation (c.2890C > T; p.R964C) associated with ovarian dysfunction. Sanger sequencing was used to validate. In silico analysis suggested that the p.R964C mutation was pathogenic. Conservation analysis demonstrated that R964 was an important site for the DNA polymerase function of POLG. CONCLUSIONS Biallelic mutations in POLG may be associated with ovarian dysfunction. This study has improved our understanding of POLG-related genetic mutations in ovarian dysfunction, and the mode of inheritance of certain sequence variants. This information will assist genetic counseling and precision medicine in the future.
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Affiliation(s)
- B Chen
- a Department of Obstetrics and Gynecology , Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University , Hefei , China.,b Institute of Reproductive Genetics , Anhui Medical University , Hefei , China.,c Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs , Hefei , China
| | - L Li
- d Central Laboratory, Beijing Obstetrics and Gynecology Hospital , Capital Medical University , Beijing , China
| | - J Wang
- e Department of Medical Genetics and Developmental Biology , School of Basic Medical Sciences, Capital Medical University , Beijing , China
| | - Y Zhou
- a Department of Obstetrics and Gynecology , Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University , Hefei , China.,b Institute of Reproductive Genetics , Anhui Medical University , Hefei , China.,c Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs , Hefei , China
| | - J Zhu
- a Department of Obstetrics and Gynecology , Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University , Hefei , China.,b Institute of Reproductive Genetics , Anhui Medical University , Hefei , China.,c Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs , Hefei , China
| | - T Li
- f Center for Genetics , National Research Institute for Family Planning , Beijing , China
| | - H Pan
- f Center for Genetics , National Research Institute for Family Planning , Beijing , China
| | - B Liu
- f Center for Genetics , National Research Institute for Family Planning , Beijing , China
| | - Y Cao
- a Department of Obstetrics and Gynecology , Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University , Hefei , China.,b Institute of Reproductive Genetics , Anhui Medical University , Hefei , China.,c Anhui Provincial Engineering Technology Research Center for Biopreservation and Artificial Organs , Hefei , China
| | - B Wang
- a Department of Obstetrics and Gynecology , Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University , Hefei , China.,f Center for Genetics , National Research Institute for Family Planning , Beijing , China.,g Key Laboratory of Family Planning and Reproductive Genetics , National Health and Family Planning Commission, Hebei Research Institute for Family Planning , Hebei , China
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Juárez-Rendón KJ, García-Ortiz JE. "Evaluation of four genes associated with primary ovarian insufficiency in a cohort of Mexican women". J Assist Reprod Genet 2018; 35:1483-1488. [PMID: 29916099 DOI: 10.1007/s10815-018-1232-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/01/2018] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Primary ovarian insufficiency (POI) is a clinical condition observed in women younger than 40 years of age, characterized by amenorrhea, hypoestrogenism, high levels of follicle-stimulating hormone (FSH), and infertility. Mutations in some master regulators of the development, maturation, and maintenance of ovarian follicles such as BMP15, FSHR, FOXL2, and GDF9 have been suggested as etiological factors in the development of POI. The aim of this study, the first in the Mexican population, is to evaluate the presence of mutations or polymorphisms in these four candidate genes. METHODS In a sample of 20 Mexican patients with idiopathic POI, we looked for and analyzed genetic variants in BMP15, FSHR, FOXL2, and GDF9 genes. RESULTS We observed two polymorphisms: a coding change, c.919G>A (p.Ala307Thr), in the FSHR gene and a synonymous variant, c.447C>T (p.Thr149Thr), in the GDF9 gene. These two variants have been reported previously as polymorphisms (rs6165 and rs254286, respectively). We observed no significant difference associated with POI in the patients when compared with a healthy control group (p > 0.05). Also, no exonic variants were found for the genes BMP15 and FOXL2 in the individuals tested. CONCLUSIONS The lack of association of the evaluated genes in this sample of Mexican women is consistent with the complex genetic etiology of POI that is observed across cohorts studied thus far.
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Affiliation(s)
- K J Juárez-Rendón
- CONACyT Research Fellow-Centro de Biotecnología Genómica, Instituto Politécnico Nacional, Laboratorio de Medicina de Conservación, Blvd. del Maestro S/N, Esq. Elías Piña, 88710, Reynosa, Tamaulipas, Mexico
| | - J E García-Ortiz
- División de Genética, Centro de Investigación Biomédica de Occidente, Centro Médico Nacional de Occidente, Laboratorio de Bioquímica 1B, Instituto Mexicano del Seguro Social, Sierra Mojada 800, 44340, Guadalajara, Jalisco, Mexico. .,Dirección de Educación e Investigación en Salud, UMAE, Hospital de Gineco-Obstretricia, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico.
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