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What Does the Data Show for Primary Ovarian Insufficiency?

  • Reproductive Endocrinology and Infertility (REI) (R Anchan, Section Editor)
  • Published:
Current Obstetrics and Gynecology Reports Aims and scope Submit manuscript

An Erratum to this article was published on 09 March 2017

Abstract

Purpose of Review

Primary ovarian insufficiency (POI), a clinical syndrome, is defined by the exhaustion of the functional potential of ovaries prior to 40 years. The consequences of POI are potentially serious for long-term fertility, reproductive health, and general health because of early menopause. This article provides an updated review of different etiologic factors and pathogenic mechanisms that lie behind POI as well as current and novel strategies for the management of this challenging disease aimed at the primary prevention of the adverse effects of estrogen deficiency and infertility related to the early loss of ovarian function.

Recent Findings

POI is considered as a multifactorial and heterogeneous condition with a wide spectrum of causes, such as cytogenetic, autoimmune, infectious, metabolic, or iatrogenic causes. Most women affected with isolated POI still appear sporadically, and the exact underlying pathology remains unknown. For early prediction of the risk of POI and prevention of the detrimental consequences of POI in terms of fecundity and general health, the determination of characteristics and the risk assessment of the POI population may be more important than the prediction of the prevalence of POI in the general population.

Summary

POI has widespread consequences for general health and fertility. Challenges remain in the modalities of assessment and management of this complex condition. This review primarily focuses on the key questions and recommendations for clinical practice regarding the assessment and management of women diagnosed with POI. Therefore, this article provides an updated review of novel findings regarding the diagnosis and management of this challenging disease.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Alvaro Mercadal B, Imbert R, Demeestere I, Gervy C, De Leener A, Englert Y, Costagliola S, Delbaere A. AMH mutations with reduced in vitro bioactivity are related to premature ovarian insufficiency. Hum Reprod. 2015;30(5):1196–202.

    Article  CAS  PubMed  Google Scholar 

  2. Albright F, Smith P, Fraser R. A syndrome characterized by primary ovarian insufficiency and decreased stature. Am J Med Sci. 1942;204:625–48.

    Article  Google Scholar 

  3. De Vos M, Devroey P, Fauser BC. Primary ovarian insufficiency. Lancet. 2010;11:376(9744):911–21.

    Article  Google Scholar 

  4. Nelson LM. Clinical practice. Primary ovarian insufficiency. N Engl J Med. 2009;360:606–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Bachelot A, Rouxel A, Massin N, Dulon J, Courtillot C, Matuchansky C, Badachi Y, Fortin A, Paniel B, Lecuru F, Lefrère-Belda MA, Constancis E, Thibault E, Meduri G, Guiochon-Mantel A, Misrahi M, Kuttenn F. Touraine P; POF-GIS study group phenotyping and genetic studies of 357 consecutive patients presenting with premature ovarian failure. Eur J Endocrinol. 2009;161(1):179–87.

    Article  CAS  PubMed  Google Scholar 

  6. Voorhuis M, Onland-Moret NC, van der Schouw YT, Fauser BCJM, Broekmans FJ. Human studies on genetics of the age at natural menopause: a systematic review. Hum Reprod Update. 2010;16:364–77.

    Article  CAS  PubMed  Google Scholar 

  7. Broekmans FJ, Soules MR. Fauser BC ovarian aging: mechanisms and clinical consequences. Endocr Rev. 2009;30(5):465–93.

    Article  CAS  PubMed  Google Scholar 

  8. Anasti J. Premature ovarian failure: an update. Fertil Steril. 1998;70:1–15.

    Article  CAS  PubMed  Google Scholar 

  9. Richardson MC, Guo M, Fauser BC, Macklon NS. Environmental and developmental origins of ovarian reserve. Hum Reprod Update. 2014;20(3):353–69.

    Article  CAS  PubMed  Google Scholar 

  10. Daan NM, Hoek A, Corpeleijn E, Eijkemans MJ, Broekmans FJ, Fauser BC, Koster MP. Reproductive characteristics of women diagnosed with premature ovarian insufficiency. Reprod BioMed Online. 2016;32(2):225–32.

    Article  PubMed  Google Scholar 

  11. • Haller-Kikkatalo K, Uibo R, Kurg A, Salumets A. The prevalence and phenotypic characteristics of spontaneous premature ovarian failure: a general population registry-based study. Hum Reprod. 2015;30(5):1229–38. They include the most updated information related to prevalence, characteristics

    Article  CAS  PubMed  Google Scholar 

  12. •• Webber L, Davies M, Anderson R, Bartlett J, Braat D, Cartwright B, Cifkova R, de Muinck K-SS, Hogervorst E, Janse F, Liao L, Vlaisavljevic V, Zillikens C, Vermeulen N. European Society for Human Reproduction and Embryology (ESHRE) guideline group on POI. ESHRE guideline: management of women with premature ovarian insufficiency. Hum Reprod. 2016;31(5):926–37. They include the most updated guideline by ESHRE related to the management of women with POI

  13. •• Qin Y, Xue J, Simpson JL, Che Z-J. Genetics of primary ovarian insufficiency: new developments and opportunities. Hum Reprod Update. 2015;21:787–808. They include the most updated information related to new developments for POI

    Article  PubMed  PubMed Central  Google Scholar 

  14. Vichinsartvichai P. Primary ovarian insufficiency associated with autosomal abnormalities: from chromosome to genome-wide and beyond. Menopause. 2016;23(7):806–15.

    Article  PubMed  Google Scholar 

  15. Wittenberger MD, Hagerman RJ, Sherman SL, McConkie-Rosell A, Welt CK, Rebar RW, Corrigan EC, Simpson JL, Nelson LM. The FMR1 premutation and reproduction. Fertil Steril. 2007;3:456–65.

    Article  Google Scholar 

  16. Simpson JL. Genetic and phenotypic heterogeneity in ovarian failure: overview of selected candidate genes. Ann N Y Acad Sci. 2008;1135:146–54.

    Article  PubMed  Google Scholar 

  17. van Dooren M, Bertoli-Avellab A, Oldenburg R. Premature ovarian failure and gene polymorphisms. Curr Opin Obstet Gynecol. 2009;21:313–7.

    Article  PubMed  Google Scholar 

  18. Aboura A, Dupas C, Tachdjian G, et al. Array comparative genomic hybridization profiling analysis reveals deoxyribonucleic acid copy number variations associated with premature ovarian failure. J Clin Endocrinol Metab. 2009;94:4540–6.

    Article  CAS  PubMed  Google Scholar 

  19. Cervera R, Balasch J. Bidirectional effects on autoimmunity and reproduction. Hum Reprod Update. 2008;14:359–66.

    Article  CAS  PubMed  Google Scholar 

  20. Faubion SS, Kuhle CL, Shuster LT, Rocca WA. Long-term health consequences of premature or early menopause and considerations for management. Climacteric. 2015;18(4):483–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Cox L, Liu JH. Primary ovarian insufficiency: an update. Int J Women's Health. 2014;6:235–43.

    Google Scholar 

  22. •• Sassarini J, Lumsden MA, Critchley HO. Sex hormone replacement in ovarian failure–new treatment concepts. Best Pract Res Clin Endocrinol Metab. 2015;29(1):105–14. They include one of the most updated concept for hormone replacement treatment of POI

  23. Roeters van Lennep JE, Heida KY, Bots ML, Hoek A. Collaborators of the Dutch multidisciplinary guideline development group on cardiovascular risk management after reproductive disorders cardiovascular disease risk in women with premature ovarian insufficiency: A systematic review and meta-analysis. Eur J Prev Cardiol. 2016;23(2):178–86.

    Article  PubMed  Google Scholar 

  24. Tao XY, Zuo AZ, Wang JQ, Tao FB. Effect of primary ovarian insufficiency and early natural menopause on mortality: a meta-analysis. Climacteric. 2016;19(1):27–36.

    Article  PubMed  Google Scholar 

  25. Schnatz PF. The 2010 North American Menopause Society position statement: updates on screening, prevention and management of postmenopausal osteoporosis. Conn Med. 2011;75(8):485–7.

    PubMed  Google Scholar 

  26. Sambrook P, Cooper C. Osteoporosis. Lancet. 2006;367:2010–8.

    Article  CAS  PubMed  Google Scholar 

  27. Bidet M, Bachelot A, Bissauge EE, Golmard JL, Gricout S, Dulon J, Coussieu C, Badachi Y, Touraine P. Resumption of ovarian function and pregnancies in 358 patients with premature ovarian failure. J Clin Endocrinl Metab. 2011;96:3864–72.

    Article  CAS  Google Scholar 

  28. Donnez J, Dolmans MM. Fertility preservation in women. Nat Rev Endocrinol. 2013;9(12):735–49.

    Article  CAS  PubMed  Google Scholar 

  29. Robles A, Checa MA, Prat M, Carreras R. Medical alternatives to oocyte donation in women with premature ovarian failure: a systematic review. Gyn Endocrinol. 2013;29:632–7.

    Article  Google Scholar 

  30. Kawamura K, Cheng Y, Sun YP, Zhai J, Diaz-Garcia C, Simon C, Pellicer A, Hsueh AJ. Ovary transplantation: to activate or not to activate. Hum Reprod. 2015;30(11):2457–60.

    Article  PubMed  Google Scholar 

  31. •• Kawamura K, Kawamura N, Hsueh AJ. Activation of dormant follicles: a new treatment for premature ovarian failure? Curr Opin Obstet Gynecol. 2016;28(3):217–22. They include the most updated information related to new developments, opportunities, management (12-ESHRE guideline; 22-HRT) and new treatment concepts for POI

    Article  PubMed  Google Scholar 

  32. StoopD BM, Haentjens P, Polyzos NP, DeVos M, Verheyen G, Camus M, Devroey P. Obstetric outcome in donor oocyte pregnancies: a matched-pair analysis. Reprod Biol Endocrinol. 2012;10:42.

    Article  Google Scholar 

  33. Naredi N, Sandeep K, Jamwal VDS. Can hormone replacement therapy prior to oocyte donation cycle in women with premature ovarian failure improve pregnancy rate? Med J Armed Forces India. 2013;69:357–60.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Podfigurna Stopa A, Czyzyk A, Grymowicz M, Smolarczyk R, Katulski K, Czajkowski K, Meczekalski B. Premature ovarian insufficiency: the context of long-term effects. J Endocrinol Investig. 2016;39:983–90.

    Article  CAS  Google Scholar 

  35. Suzuki N, Yoshioka N, Takae S, Sugishita Y, Tamura M, Hashimoto S, Morimoto Y, Kawamura K. Successful fertility preservation following ovarian tissue vitrification in patients with primary ovarian insufficiency. Hum Reprod. 2015;30:608–15.

    Article  PubMed  Google Scholar 

  36. •• VanderVen H, Liebenthron J, Beckmann M, Toth B, Korell M, Krus sel J, Frambach T, Kupka M, Hohl MK, Winkler-Crepaz K, Seitz S, Dogan A, Griesinger G, Haberlin F, Henes M, Schwab R, Sutterlin S, von Wolff M, Dittrich R. On behalf of the Ferti PROTEKT network ninety-five orthotopic transplantations in 74 women of ovarian tissue after cytotoxic treatment infertility preservation network: tissue activity, pregnancy and delivery rates. Hum Reprod. 2016;31:2031–41. They include the most updated information related to new developments, opportunities, management (12-ESHRE guideline; 22-HRT) and new treatment concepts for POI

    Article  CAS  Google Scholar 

  37. Donnez J, Dolmans MM. Ovarian cortex transplantation: 60 reported live births brings the success and worldwide expansion of the technique towards routine clinical practice. J Assist Reprod Genet. 2015;32:1167–70.

    Article  PubMed  PubMed Central  Google Scholar 

  38. • Chapman C, Cree L, Shelling AN. The genetics of premature ovarian failure: current perspectives. Int J Womens Health. 2015;23(7):799–810. They include the most updated information related to prevalence, characteristics and genetics of POI

    Google Scholar 

  39. Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2015;103(3):9–17.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Bezmialem University, İstanbul, Turkey

    Pınar Özcan

  2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Pınar Özcan & Parveen Parasar

  3. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Yeditepe University, Faculty of Medicine, Istanbul, Turkey

    Cem Fıçıcıoğlu

Authors
  1. Pınar Özcan
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  2. Parveen Parasar
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  3. Cem Fıçıcıoğlu
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Corresponding author

Correspondence to Pınar Özcan.

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Conflict of Interest

Pınar Özcan, Parveen Parasar, and Cem Fıçıcıoğlu declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Reproductive Endocrinology and Infertility (REI)

The original version of this article was revised: The name of author Parveen Parvasar was changed to Parveen Parasar as requested by authors.

An erratum to this article is available at http://dx.doi.org/10.1007/s13669-017-0199-x.

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Özcan, P., Parasar, P. & Fıçıcıoğlu, C. What Does the Data Show for Primary Ovarian Insufficiency?. Curr Obstet Gynecol Rep 6, 26–32 (2017). https://doi.org/10.1007/s13669-017-0191-5

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  • DOI: https://doi.org/10.1007/s13669-017-0191-5

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