“…XX disorders of sexual development (XX-DSD) are infrequent (1), and (46-XX) females with isolated hypergonadotropic ovarian dysgenesis (MIM #233300) constitute a rare, genetically heterogeneous condition. In recent years, XX-DSD with ovarian dysgenesis have been shown to be caused by autosomal recessive mutations in the genes encoding the follicle-stimulating hormone (FSH) receptor, WNT4 (2, 3), R-spondin (4,5), PSMC3IP (6), MCM9 (7), MCM8 (8,9), STAG3 (10), and SYCE1 (11) or by X-linked recessive mutations in BMP15 (12,13). These and other studies indicate that ovarian development is an active process involving signaling pathways and crosstalk between somatic and germ cells and not simply a passive process unfolding in the absence of SRY, the testis determining gene on the Y chromosome (14).…”