General mechanisms of premature ovarian failure and clinical check-up

Premature ovarian failure (POF) is defined as the cessation of ovarian function under the age of 40 years. It is characterized by primary or secondary amenorrhea for at least four months, sex steroid deficiency and elevated serum gonadotropin concentrations. The diagnosis is confirmed by the detection of menopausal FSH levels on at least two occasions a few weeks apart in a woman before the age of 40. It occurs in 1/10,000 in women below the age of 20, 1/1,000 below 30 and 1% in women before the age of 40. Tthe classic etiologies are Turner syndrome, pelvic surgery, radiotherapy or chemotherapy. Although new genetic etiologies have been found in the past 10 years, the cause of POF is unknown in more than 75% of cases. Hormone replacement therapy should be administered in order to avoid vascular diseases and osteoporosis. For infertility, the most successful treatment remains assisted conception with donated oocytes.