DOI: https://doi.org/10.18370/2309-4117.2019.49.58-61

Modern aspects of management of patients with premature ovarian failure

О. Г. Градиль, О. В. Грищенко, Н. М. Пасиешвили, В. В. Лазуренко, В. Г. Карпенко

Abstract


Premature ovarian failure (POF) is still a disease with an unknown etiology; questions of early diagnosis and treatment remain open. POF is associated with typical menopausal symptoms which develop before the age of 40 years.

The authors’ study involved 97 patients aged 26 to 38 years without somatic pathology. The main complaint was menstrual dysfunction as irregular menstruation for 12 months. A complex of clinical and laboratory studies was carried out, including hormonal examination and pelvic ultrasonography. As additional studies we determined the anti-Müllerian hormone level, antral follicles count and measuring the ovaries volume during ultrasound examination.

The study identified three groups. Group I consisted of patients without hormonal imbalance (most showed a pronounced psycho-emotional component). Group II consisted of patients with hormonal disorders, such as hyperprolactinemia and increased androgens levels (an additional analysis in such patients was an insulin resistance test, HOMA index). Group III consisted of patients with menstrual dysfunctions as persistent opsomenorrhea and oligomenorrhea (early menopause on the maternal side was noted in most patients in this group).

The estimated time of onset of menopause was calculated using a mathematical formula, and an assessment of the risk of cardiovascular disease in connection with the onset of early menopause. A follow-up 12-month follow-up was performed for patients who were planning a pregnancy. The indicators of the onset of spontaneous pregnancy were calculated with reduced rates of ovarian reserve.

Results of the study showed that early POF diagnosis allows reducing the frequency of infertility in such women by 33.3% and gives chances of obtaining ovum from the mother, not the donor, without the assisted reproductive technologies. Hormone replacement therapy in patients with POF improves the life quality and reduces the cardiovascular risk. Early diagnosis of POF risks allows infertility prevention

Keywords


premature ovarian failure; primary ovarian insufficiency; hormone replacement therapy; menopause; infertility treatment

References


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Laven, J.S.E. 3. Webber, L., Davies, M., Anderson, R., et al. “ESHRE guideline: management of women with premature ovarian insufficiency.” Hum Reprod 31 (2016): 926–37.

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Ryan, J., Scali, J., Carriere, I., et al. “Impact of a premature menopause on cognitive function in later life.” BJOG 121 (2014): 1729–39.

Roswall, N., Sandin, S., Adami, H.O., Weiderpass, E. “Cohort profile: the Swedish Women's Lifestyle and Health cohort.” Int J Epidemiol 46.2 (2017): e8. DOI: 10.1093/ije/dyv089

He, C., Murabito, J.M. “Genome-wide association studies of age at menarche and age at natural menopause.” Mol Cell Endocrinol 382 (2014): 767–79.

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Gulhan, I., Bozkaya, G., Uyar, I., et al. “Serum lipid levels in women with premature ovarian failure.” Menopause 19 (2012): 1231–4.

Cappelletti, M., Wallen, K. “Increasing women's sexual desire: the comparative effectiveness of estrogens and androgens.” Horm Behav 78 (2016): 178–93.

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GOST Style Citations


1.         Kovanci, E., Schutt, A.K. “Premature ovarian failure: clinical presentation and treatment.” Obstet Gynecol Clin North Am 42 (2015): 153–61.

2.         Laven, J.S.E.  3.         Webber, L., Davies, M., Anderson, R., et al. “ESHRE guideline: management of women with premature ovarian insufficiency.” Hum Reprod 31 (2016): 926–37.

4.         Muka, T., Oliver-Williams, C., Kunutsor, S., et al. “Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes, intermediate vascular traits, and all-cause mortality: a systematic review and meta-analysis.” JAMA cardiol 1 (2016): 767–76.

5.         Ryan, J., Scali, J., Carriere, I., et al. “Impact of a premature menopause on cognitive function in later life.” BJOG 121 (2014): 1729–39.

6.         Roswall, N., Sandin, S., Adami, H.O., Weiderpass, E. “Cohort profile: the Swedish Women's Lifestyle and Health cohort.” Int J Epidemiol 46.2 (2017): e8. DOI: 10.1093/ije/dyv089

7.         He, C., Murabito, J.M. “Genome-wide association studies of age at menarche and age at natural menopause.” Mol Cell Endocrinol 382 (2014): 767–79.

8.         Muka, T., Oliver-Williams, C., Kunutsor, S., et al. “Association of age at onset of menopause and time since onset of menopause with cardiovascular outcomes, intermediate vascular traits, and all-cause mortality: a systematic review and meta-analysis.” JAMA cardiol 1 (2016): 767–76.

9.         Gulhan, I., Bozkaya, G., Uyar, I., et al. “Serum lipid levels in women with premature ovarian failure.” Menopause 19 (2012): 1231–4.

10.       Cappelletti, M., Wallen, K. “Increasing women's sexual desire: the comparative effectiveness of estrogens and androgens.” Horm Behav 78 (2016): 178–93.

11.       Akbari Asbagh, F., Ebrahimi, M. “A case report of spontaneous pregnancy during hormonal replacement therapy for premature ovarian failure.” Iranian Journal of Reproductive Medicine 9.1 (2011): 47–9.

12.       Day, F.R., Ruth, K.S., Thompson, D.J., et al. “Large-scale genomic analyses link reproductive aging to hypothalamic signaling, breast cancer susceptibility and BRCA1-mediated DNA repair.” Nat Genet 47 (2015): 1294–1303.

13.       Qin, Y., Jiao, X., Simpson, J.L., et al. “Genetics of primary ovarian insufficiency: new developments and opportunities.” Hum Reprod Update 21.6 (2015): 787–808. DOI: 10.1093/humupd/dmv036

14.       Chapman, C., Cree, L., Shelling, A.N. “The genetics of premature ovarian failure: current perspectives.” Int J Womens Health 7 (2015): 799–810. DOI: 10.2147/IJWH. S64024

15.       Barasoain, M., Barrenetxea, G., Huerta, I., et al. “Study of the Genetic Etiology of Primary Ovarian Insufficiency: FMR1 Gene.” Genes (Basel) 7.12 (2016). DOI: 10.3390/genes7120123

16.       Ebrahimi, M., Akbari Asbagh, F. “Pathogenesis and causes of premature ovarian failure: An Update.” Int J Fertil Steril 5.2 (2011): 54–65.

17.       Laissue, P. “Aetiological coding sequence variants in non-syndromic premature ovarian failure: From genetic linkage analysis to next generation sequencing.” Mol Cell Endocrinol 411 (2015): 243–57.

18.       Taneri, P.E., Kiefte-de Jong, J.C., Bramer, W.M., et al. “Association of alcohol consumption with the onset of natural menopause: a systematic review and meta-analysis.” Hum Reprod Update 22 (2016): 516–28.

19.       Cade, J.E., Burley, V.J., Alwan, N.A., et al. “Cohort profile: the UK Women's Cohort Study (UKWCS).” Int J Epidemiol 46.2 (2017): e11. DOI: 10.1093/ije/dyv173

20.       Sarrel, P.M., Sullivan, S.D., Nelson, L.M. “Hormone replacement therapy in young women with surgical primary ovarian insufficiency.” Fertil Steril 106.7 (2016): 1580–7. DOI: 10.1016/j.fertnstert.2016.09.018

21.       Webber, L., Davies, M., et al.: ESHRE Guideline Group on POI. “ESHRE Guideline: management of women with premature ovarian insufficiency.” Hum Reprod 31.5 (2016): 926–37. DOI: 10.1093/humrep/dew027

22.       Mishra, G.D., Chung, H.F., Pandeya, N., et al. “The InterLACE study: design, data harmonization and characteristics across 20 studies on women's health.” Maturitas 92 (2016): 176–85.

23.       Schoenaker, D.A., Jackson, C.A., Rowlands, J.V., et al. “Socioeconomic position, lifestyle factors and age at natural menopause: a systematic review and meta-analyses of studies across six continents.” Int J Epidemiol 43.5 (2014): 1542–62. DOI: 10.1093/ije/dyu094

24.       Азаренкова, Т.А., Вардугина, Н.Г. Способ определения возраста наступления менопаузы у женщин как фактора риска сердечно-сосудистых заболеваний. Патент Российская Федерация № 2564759 (2015).





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ISSN 2411-1295 (Online), ISSN 2309-4117 (Print)