The time is now for a new approach to primary ovarian insufficiency

Cooper, Amber R.; Baker, Valerie L.; Sterling, Evelina W.; Ryan, Mary; Woodruff, Teresa K.; Nelson, Lawrence M.

doi:10.1016/j.fertnstert.2010.01.016

Cited by 100 publications

(65 citation statements)

References 25 publications

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“…The ongoing development of an online international registry [115] should help provide such data and create an evidence-based for care [116]. The urgent need for international collaboration has been recognized [117][118][119][120] and will be vital for the development of standardized guidelines to improve the diagnosis and treatment of the condition.…”

Section: Conclusion and Future Perspectivementioning

confidence: 99%

Current Concepts in Premature Ovarian Insufficiency

Maclaran

Panay

2015

Womens Health (Lond Engl)

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Premature ovarian insufficiency (POI) is a life-changing diagnosis, with profound physical and psychological consequences. Unfortunately, there are many deficiencies in our understanding of the condition as the underlying etiology and optimum management strategies are poorly understood. Improved awareness of POI and its long-term implications has led to increased research interest in recent years. Current research has allowed a greater understanding of the changing epidemiology in POI, genetic factors in its etiology and randomized controlled trials of hormone therapy are underway to provide evidence for treatment. This article reviews the latest literature on POI to summarize current understanding and future directions. Premature ovarian insufficiency (POI) is a life-changing diagnosis, with profound physical and psychological consequences, affecting approximately one in 100 women by the age of 40 years [1]. Unfortunately, there are many deficiencies in our understanding of the condition as the underlying etiology and optimum management strategies are poorly understood. Furthermore, controversy exists surrounding the terminology and diagnostic criteria, all of which can have a significant impact on the patients' well-being.Improved awareness of POI and its longterm implications has led to increased research interest in recent years. Current research has allowed a greater understanding of the changing epidemiology in POI, genetic factors in its etiology and randomized controlled trials (RCTs) of hormone therapy (HT) are underway to provide evidence for treatment. Here we aim to review the latest literature on POI to summarize current understanding and future directions. TerminologyThere has been a long-standing lack of consensus over the nomenclature of the disorder, with a variety of other terms in use, such as primary ovarian insufficiency, premature ovarian failure, premature menopause and hypergonadotrophic hypogonadism. We use the term premature ovarian insufficiency as it encompasses both spontaneous POI and the increasing number of women who have suffered POI as a result of iatrogenic interventions. The term insufficiency, rather than failure, is thought to more accurately reflect the unpredictable nature of ovarian function in the disorder as intermittent ovarian function, resulting in ovulation and even pregnancy, can occur [2,3]. The use of the term 'premature' refers to the timeline rather than the etiology, that is, ovarian insufficiency which has occurred before 40 years of age from any cause. It is important to note, however, that the condition does not always develop by the same mechanism as the normal menopause, which is due to follicle depletion. For example, some women develop POI due to mutations in the follicle stimulating hormone (FSH) receptor -these women have follicles in the ovary that are unable to function. Another example is steroidogenic cell POI has traditionally been defined as the triad of amenorrhea, elevated gonadotrophins and estrogen deficiency occurring in women under the age...

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Section: Conclusion and Future Perspectivementioning

confidence: 99%

Current Concepts in Premature Ovarian Insufficiency

Maclaran

Panay

2015

Womens Health (Lond Engl)

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“…It is also sometimes described as primary ovarian insufficiency. 3 Early loss of ovarian function has significant psychosocial sequelae due to poor reproductive performance but also has major health implications. 4 Nearly, two-fold age-specific increase in mortality rate has been reported 5 in patients with premature menopause.…”

Section: 5005/jp-journals-10016-1060mentioning

confidence: 99%

“…Previous POR with ≤3 oocytes retrieved in previous conventional stimulation. 3. Abnormal ovarian reserve tests AFC <5 to 7 or AMH <0.5 to 1.1 ng/ml.…”

Section: Managementmentioning

confidence: 99%

Diminished Ovarian Reserve, Causes, Assessment and Management

Arora¹,

Kaur²

2013

International Journal of Infertility &Amp; Fetal Medicine

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Diminished ovarian reserve predicts diminished ovarian response to stimulation but does not predict cycle fecundity. It has been recently defined by ESHRE, the Bologna's criteria, according to which at least two of the following three features should be present: (1) Age >40 years/any other risk factor for DOR, (2) abnormal ovarian reserve test, i.e. antral follicle count, AMH, (3) poor ovarian response in a previous stimulated cycle, i.e. less than three follicles after standard gonadotropin stimulation. Poor response to maximal stimulation on two previous occasions also defines DOR.The treatment options are limited. Avoiding the GnRH agonist long protocol and stimulation with microdose flare or antagonist protocol yields better results. Adjuvant therapy with LH, DHEAS and growth hormone shows some benefit in improving the oocyte yield. It is advisable to perform ICSI for all obtained oocytes and some advocate assisted hatching. Pregnancy rates are, however, poor and often these patients require ovum donation. Developing tests that will diagnose DOR in a low-risk population will allow women to plan their reproductive careers early.

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“…There is not a good understanding about the pathophysiology, natural history, psychosocial effects, medical and psychosocial management of primary ovarian insufficiency (Cooper et al 2011) [8].…”

Section: Introductionmentioning

confidence: 99%

Effect of<i> Mentha longifolia</i> on FSH Serum Level in Premature Ovarian Failure

Mokaberinejad¹,

Akhtari²,

Tansaz³

et al. 2014

OJOG

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Purpose: Premature ovarian failure (POF) includes cessation of normal ovarian function before age 40, causing amenorrhea, menopausal symptoms and general health problems. Hormone replacement therapy (HRT) can be administered in order to prevent menopausal symptoms, osteoporosis and vascular complications. Due to the contraindications and side effects of HRT and the increasing demand for alternative therapeutic modalities, we used Mentha longifolia, which is known in the Iranian traditional medicine (ITM), as being able to cause menstrual bleeding in women with early amenorrhea and decreased FSH serum. Methods: In this pilot study, we report twenty seven amenorrheic women with POF who were referred to the Iranian traditional medicine clinic in Tehran and treated by Mentha longifolia. All those patients had high FSH levels and amenorrhea. They were in their fertility age, between 30 to 40 years old. They were asked to take a cup of herbal tea which was steeped with Mentha longifolia tea three times a day for 2 weeks in 3 menstural cycles. If the patients developed menstruation, the FSH serum level was * Corresponding author. R. Mokaberinejad et al.357 measured immediately; otherwise they had an FSH measurement one month after the beginning of therapy. Results: Mean age of patients was 36.44 ± 1.5 years. Mean FSH level before treatment was 79.13 ± 19.17 mIU/ml, and after treatment was 27.83 ± 16.14 mIU/ml. In four patients who did not have any response, mean range of FSH was 82.37 ± 19.75 mIU/ml before treatment and afterwards it was 81.97 ± 21.52 mIU/ml. After treatment with herbal teas, there was a significant decrease in FSH (79.39 ± 19.17 to 27.83 ± 16.14 mIU/ml, p value < 0.001). All patient except four (14.81%) had mensturation after taking the herbal medicine. Those four patients showed no decrease in FSH level. More of the patients who used medicinal tea achieved regular monthly bleeding when followed for three cycles.

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The time is now for a new approach to primary ovarian insufficiency

Cited by 100 publications

References 25 publications

Current Concepts in Premature Ovarian Insufficiency

Current Concepts in Premature Ovarian Insufficiency

Diminished Ovarian Reserve, Causes, Assessment and Management

Effect of<i> Mentha longifolia</i> on FSH Serum Level in Premature Ovarian Failure

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The time is now for a new approach to primary ovarian insufficiency

Cited by 100 publications

References 25 publications

Current Concepts in Premature Ovarian Insufficiency

Current Concepts in Premature Ovarian Insufficiency

Diminished Ovarian Reserve, Causes, Assessment and Management

Effect of&lt;i&gt; Mentha longifolia&lt;/i&gt; on FSH Serum Level in Premature Ovarian Failure

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Effect of<i> Mentha longifolia</i> on FSH Serum Level in Premature Ovarian Failure