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Immunological Underpinnings of Autoimmune Primary Ovarian Insufficiency

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Abstract

Purpose of Review

Primary ovarian insufficiency (POI) is a heterogenous disease with numerous causes, affecting ~ 1% of women in the USA. The autoimmune-driven subset is even less common and afflicts approximately 4% of POI patients. Although primary ovarian insufficiency is rare, the consequences of early menopause are significant and can lead to osteopenia, infertility, mental health problems, and sexual dysfunction.

Recent Findings

In vitro maturation of oocytes and IVF may be a promising fertility treatment option for POI patients. Experimental treatments, such as stem cell therapy and intraovarian platelet-rich plasma, may be promising for both infertility treatment and ovarian function to prevent sequelae of premature menopause.

Summary

Autoimmune POI can diverge from other forms of POI in both presentation and disease course. Autoimmune POI is frequently associated with other autoimmune endocrine disorders. There are no consensus guidelines on the treatment of autoimmune POI; however, hormone therapy should be provided to prevent sequelae of premature menopause, and fertility preservation should be offered to autoimmune POI patients, since they may have residual ovarian follicles.

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA

    Tia Y. Brodeur

  2. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Medical Center, 111 Colchester Ave, Burlington, VT, 05401, USA

    Navid Esfandiari

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Brodeur, T.Y., Esfandiari, N. Immunological Underpinnings of Autoimmune Primary Ovarian Insufficiency. Curr Obstet Gynecol Rep 13, 1–8 (2024). https://doi.org/10.1007/s13669-024-00376-z

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  • DOI: https://doi.org/10.1007/s13669-024-00376-z

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