Premature Ovarian Insufficiency Failure

Premature ovarian failure
Premature ovarian failure (Hence forth referred to as POF) is a condition where ovarian capacity of producing follicles giving oocytes reduces. This occurs due to decrease in production of hormone estrogen by ovaries. Estrogen hormone controls menstrual periods & helps in fertility. With increasing age, say around menopause which usually occurs from 40-50 years, ovaries eventually stop making estrogen. In Premature ovarian failure this process take place at early age during the fertile phase of female’s life. Reduced estrogen levels lead to dysfunction of follicles, affecting fertility adversely.

What are the causes of premature ovarian failure ?
Genetically, ovaries are having less follicles which hold eggs as they grow & mature. Auto immune disorder, that means your body produce antibodies to your ovaries resulting in depletion of functional capacity. Chemotherapy & radiation therapy given for treatment of ovarian cancer. Chromosomal disorders like Fragile X syndrome & turner syndrome.

What problems occur in case of premature ovarian failure?
Due to estrogen depletion in body, patient generally suffers from symptoms which happens during menopause #Infertility due to non-functional ovaries
#Hot flushes
#Night sweats
#Anxiety depression & mood swings
#Vaginal dryness & discomfort during sex
#Decrease in sex drive
#Concentration & memory problem

How the diagnosis is done ?
Usually, when periods stop or become irregular initial test done is to establish pregnancy. Only it comes negative other tests like Thyroid or Prolactin are used for evaluation.
Specific tests to confirm POF:
1. Follicular stimulating Hormone (FSH) shows higher values when premature ovarian failure occurs
2. AMH (Anti mulerian Hormone ) show very low values
3. Low estradiol level which means ovaries are not making enough estrogen
4. Transvaginal ultrasound of ovaries to know Antral Follicle Count
All above tests together confirms diagnosis of Premature Ovarian Failure

What are the side effects?
#High cholesterol & heart disease
#Osteoporosis
#Anxiety & depression
#Eye problems due to dry eyes
These all side effects are due to low level of Estrogen Hormone Treatment options POF doesn’t have any treatment for cure but with the medicine plan you can treat associated symptoms & potential complications related to low Estrogen level.

Hormone Replacement Therapy which include
Estrogen & progesterone hormones.
Calcium & Vitamin D supplements
Lifestyle modifications with Diet & Exercise like weight bearing exercise / Yoga.

Treatment options in Infertility :
Supplements to improve egg quality:
#Co enzyme Q10
#L-Arginine
#Myo-inositol
#DHEA ( helps to improve estrogen level )
#Clomiphene citrate (sometimes for egg production)
Along with these supplements treatment for egg production is done with Hormonal injections of FSH & LH. But all these treatment plans are useful only in borderline cases. Natural conception or IUI conception rarely works in such cases with one or two follicle production. Hence IVF treatment is required in this case. If patients follicles are either not being produced or not surviving, the last option is going for Donor oocyte & IVF to get conception successfully.