Primary Ovarian Insufficiency

Primary Ovarian Insufficiency

 

Primary Ovarian Insufficiency (POI) is a disorder characterized by the failure of ovaries in women who are less than 40 years of age. This condition is also called as Premature Ovarian Failure and Premature Menopause. However, these terms are misleading as women who suffer from this condition do not always stop menstruating completely nor does their ovaries completely stops functioning. When the ovaries stop functioning, it usually leads to producing lesser amounts of estrogen, or fails to release eggs regularly. This can lead to infertility.

In the Year of 1942 Fuller Albright and his team first reported the syndrome in a young women showing menopausal levels of FSH, and very low estrogen levels amenorrhea. The condition was named by the team as “primary ovarian insufficiency” to distinguish the condition from secondary ovarian insufficiency, which is the failure of the pituitary to secrete FSH.

 

Causes:

causes of POVI

  • Genetic or chromosomal defects: Some of the genetic disorders are connected to premature ovarian failure, such as Turner’s syndrome (where a woman has only X chromosome and a changed second X chromosome) and Fragile X chromosomes (where the X chromosomes are weak and can break).
  • Autoimmune disase: This is a rare condition which involves the immune system to produce antibodies against the ovarian tissue, which in turn harm and damages the egg.
  • Toxins:Failure caused by toxins is usually resulted from hysterectomy, chemotherapy and radiation therapy, which harm the genetic material in cells. Other toxins such as cigarette smoke, chemicals, pesticides and viruses can lead to Primary Ovarian failure.
  • Unknown factors:Premature Ovarian Failure can also be caused by unknown factors with no known chromosomal defects, toxin exposure or any auto immune disorder. It is declared unknown(idiopathic) after doing the thorough investigations and no anomaly is found whatsoever.

Symptoms:

symptoms of POI

  • Amenorrhea or irregular periods.
  • Having problems with conceiving.
  • Lack of interest or desire to indulge in sexual activities.
  • Hot flashes.
  • Night sweats.
  • Dryness in the vagina.
  • Difficulty concentrating.

 

Risks involved:

 

  • Age:Woman between the ages of 35-40 are at a higher risk.
  • Hereditary:A family history of premature ovarian failure increases your risk of developing this disorder.
  • Surgeries: Having undergone multiple ovarian surgeries like surgery for Ovarian endometriosis or others increases the risk of this disorder.

Complications Involved: 

complications of POVI

  • Infertility: One of the greatest complications of Primary Ovarian Insufficiency is inability to get pregnant.
    • Osteoporosis:Women who have low levels of estrogen, are at an increased risk of developing weak and brittle bones (osteoporosis).
  • Dementia: This involves a decline in the mental ability. Lack of estrogen can contribute to this disorder in some people.
  • Depression or anxiety:Low estrogen levels may cause infertility and other complications which might also lead some women to become depressed or anxious.
  • Heart disease:Loss of estrogen at an early age can contribute to an increase in the heart diseases.

Diagnosis:

diagnosis of primary ovarian inssuficiency

  • Pregnancy test: Doctors recommend a pregnancy test to detect unexpected pregnancy in a woman of childbearing.
  • FMR1 gene testing:The FMR1 gene is the gene associated with fragile X syndrome. It is an inherited disorder leading intellectual problems. The FMR1 test involves observing both the X chromosomes and ensuring that that are normal.
  • Follicle-stimulating hormone (FSH) test:FSH is a hormone released by the pituitary gland that helps the growth of follicles in your ovaries. FSH levels are abnormally high in womens having premature Ovarian Failure.
  • Karyotype:This test is recommended by the doctors to detect abnormalities in any of the 46 chromosomes.
  • Estradiol test: Women who have primary ovarian insufficiency usually have low levels of estradiol, a type of estrogen that comes from the ovaries.
  • Prolactin test: High levels of prolactin in blood can lead to problems with ovulation and infertility, including irregular or absent menstrual cycle.

Treatment:

 

  • Estrogen therapy:Estrogen therapy prevents osteoporosis and relieves other symptoms of estrogen deficiency like hot flashes. Doctors prescribe estrogen with the hormone progesterone, as the addition of progesterone shields the uterus lining from precancerous changes, which can be caused by taking progesterone alone. This combination induces vaginal bleeding. However, it is unable to restore the functioning of the ovaries. Women are allowed to take hormone therapy until the age of 50-51. Long term therapy can increase the risk of breast cancer as well as heart and blood vessel disease.
  • Calcium and vitamin D supplements: Both these supplements are essential for keeping osteoporosis at bay.
  • Infertility treatment:5-10% of women with POI are able to conceive and give birth normally without any special treatment. The treatment that is proven successful for conceiving is vitro fertilization (IVF) with donor eggs. The rate of success is completely dependent on the age of the person who donates the egg. Embryo donation, in which frozen embryos are donated to the couple, is also often successful and less expensive.

Prevention:

 

  • Keep your bones healthy, as women with POI are prone to fractures or bone thinning.
  • Consuming a balanced diet.
  • Exercising regularly.
  • Avoid smoking.
  • Intake of considerable amount of Calcium and Vitamin D. 

EvaIVF offers a low-risk way to treat Primary Ovarian Insufficiency.  Our team of experienced and skilled doctors make life at hospital a painless one and gurantee a speedy recover.

 

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