Premature ovarian failure: predictability of intermittent ovarian function and response to ovulation induction agents.
ABSTRACT To summarize our current knowledge about the predictability of intermittent ovarian function and the response to ovulation induction agents in patients with premature ovarian failure.
In addition to clinical, histological or ultrasonographic features, a new biological marker anti-Müllerian hormone, was evaluated as a marker for ovarian reserve in premature ovarian failure patients with encouraging results. Moreover, even if no treatment has proven to be effective enough to restore ovarian function, a recent study has presented a therapeutic protocol leading to a significant increase in ovulation and a higher pregnancy rate.
Intermittent ovarian function can be spontaneously observed in premature ovarian failure patients. Clinical, biological and ovarian ultrasonographic features may allow an assessment of the presence of ovarian activity, but are not necessarily correlated with a higher ovulation or pregnancy rate. Nevertheless, it appears essential to characterize these patients to determine whether some of them could be candidates who benefit from a particular therapeutic strategy, although most such strategies have not yet demonstrated their efficiency.
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ABSTRACT: Premature ovarian insufficiency (POI) is a life-changing condition that affects women in their reproductive age. The condition is not necessarily permanent but is associated with intermittent and unpredictable ovarian activity. Hence, spontaneous pregnancies have been reported to be 5-10%. However, pregnancy in patients with POI is still unlikely and rare. Although, there are reviews on POI in the literature, there is a lack of reports which focus on how to improve the reproductive outcome of these women who wish to conceive spontaneously or use assisted conception with their own oocytes. We found that there is no conclusive evidence of which treatment is optimal for women with POI who wish to conceive using their own gametes. However, one could surmise that it is important to lower gonadotropin levels into the physiological range before embarking on any treatment, even if natural conception is the only choice for the woman/couple. In the future, multi-center, randomized, double-blind, placebo-controlled trials should be carried out, which may entail recruitment of patients from various centers nationally and internationally to increase the sample size and therefore achieve a powered study. This may standardize the treatment of women with POI who wish to conceive and ultimately have their biological child.Climacteric 12/2013; · 1.96 Impact Factor
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ABSTRACT: Chemotherapeutic agents administered for the treatment of malignancies can result in the incidence of premature ovarian failure (POF). Ovarian failure is reflected by elevated serum follicle-stimulating hormone (FSH) levels that may reach menopausal levels, at which the chances of a pregnancy are considered extremely rare. We report a case of a 26-year-old female who experienced two successful pregnancies, despite her diagnosis with chemotherapy-induced POF. This case suggests that patients who suffer from POF secondary to chemotherapy might still retain enough ovarian function with good quality oocytes that could support a healthy pregnancy.Gynecological Endocrinology 11/2011; 28(4):286-7. · 1.30 Impact Factor
Article: Ovulation Induction[Show abstract] [Hide abstract]
ABSTRACT: Ovulation induction has developed as a valuable noninvasive therapy for the infertile couple. The nurse's role focuses on assisting the couple, as a unit, to understand and cope with the necessary regimen, tests, examinations, and therapies necessary to reach the goal of conception. The physiologic regulation of the menstrual cycle, current pharmacologic therapy, treatment protocols, and the unique role of the infertility nurse are reviewed.Journal of Obstetric Gynecologic & Neonatal Nursing 11/1985; 14(s6). · 1.03 Impact Factor