Overview of Premature Ovarian Failure
Premature ovarian failure (POF) or Premature Ovarian Insufficiency (POI) is a condition where the ovaries stop functioning; resulting in no egg production well before menopause. It is a rare condition where the ovaries do not produce sufficient estrogen to release the egg from the ovaries.
More often, POF is confused with premature menopause because of the similarity of symptoms. However, both conditions are not alike and women with POF have irregular menstruation and have the chances of getting pregnant.
What causes premature ovarian failure?
Premature ovarian failure, though rare, can be seen in young girls or some may have it as a birth condition; where menstruation does not take place at all. Some of the causes are:
- Genetic defects : Presence of a genetic abnormality such as Turner’s syndrome with an altered X chromosome or Fragile X syndrome with a breakable and damaged X chromosome.
- Toxin-induced ovarian failure : Side-effects of chemotherapy, radiotherapy that damage the cell’s DNA. Toxins from smoking, pesticides, harmful chemicals, can damage the ovaries causing its failure.
- Autoimmune disorder : The immune system generates an immune response against the ovarian tissue damaging the follicle and the egg.
Sometimes, certain unknown reasons also cause POF. Women between 35-40 years of age, women with a family history of POF, or who have undergone ovarian surgery are at a high risk of developing this condition.
What are the symptoms?
Similar to menopause or estrogen deficiency, common signs of POF are:
- Irregular/absence of periods.
- Difficulty attaining pregnancy.
- Feeling of intense heat with sweating.
- Frequent palpitations
- Excessive perspiration while sleeping
- Vaginal dryness
- Reduced sexual desire
- Pain during intercourse
- Lowered concentration, irritability and mood swings
It is advised to see a specialist if one is experiencing one or more above signs, has missed periods for more than three months.
Complications of primary ovarian failure include:
- Depression or anxiety
- Sexual dysfunction
- Heart disease
What are the diagnosis and treatment options?
Diagnosis of POF includes:
- Blood tests to determine estrogen levels and pituitary gland functioning. Increased pituitary hormones with decreased estrogen levels indicate POF.
- Low levels of Anti Mullerian Hormone (AMH) produced by developing antral follicles can help reaffirm the imprint of reduced ovarian reserve.
- Evaluation of thyroid function and prolactin levels is also suggested for POF to eliminate alternate pathology.
- Genetic testing helps find the presence of any chromosomal defect causing such insufficiency.
- Transvaginal ultrasound can also help check the status of the follicle-producing ovaries.
Treatment options include:
Estrogen therapy: Restoring estrogen levels is the primary treatment that can help relieve symptoms, prevent complications of POF such as osteoporosis, heart disease, and even infertility. Combination of hormones like inclusion of progesterone can protect the uterine lining and avoid the possibility of any precancerous condition.
Calcium and Vitamin D supplements: These nutrients can help ameliorate bone density and prevent osteoporosis.
Fertility treatment: Sometimes, it can get difficult to restore fertility through hormones and supplements. Fertility treatment for women with POF include IVF, donor eggs/embryos to attain pregnancy.
PRP therapy can partially restore the function of POI ovaries. It can protect morphologically normal follicles from degeneration and atresia caused by ototoxic chemicals and stimulate angiogenesis.
Treatment at OMYA:
OMYA Infertility treatment centre in Delhi has the most experienced panel of fertility specialists who handle complex female fertility concerns with prudence and precision. They have a well established infrastructure with state-of-the-art technology and provide personalized care ensuring a successful treatment outcome.