PREMATURE OVARIAN FAILURE: PATHOGENESIS, CLINICAL MANIFESTATIONS AND TREATMENT OPTIONS
Keywords:
Ovarian failure syndrome, premature ovarian failure, follicle-stimulating hormone, anti-Müllerian hormone, infertility, reproductive function, oocyte donation, assisted reproductive technologies, hormonal therapy, stem cellsAbstract
Premature ovarian failure (POF) or premature ovarian failure is one of the most common reproductive disorders in women under 40. The condition is characterized by cessation of menstruation, hypoestrogenism, and increased gonadotropin levels, which leads to infertility and other systemic disorders. The article discusses current concepts of the pathogenesis of POF, including genetic, autoimmune, and iatrogenic factors. The data of a comprehensive examination of 138 patients are analyzed, as well as the effectiveness of various approaches to restoring fertility - from hormonal therapy to the use of assisted reproductive technologies and experimental methods, such as ovarian tissue transplantation and the introduction of mesenchymal stem cells. Particular attention is paid to diagnostic criteria, prospects for individual treatment, and the need for an interdisciplinary approach. The findings highlight the need for early diagnosis and the development of new therapeutic strategies aimed at improving the prognosis in women with POF.
References
Nelson LM Clinical practice. Primary ovarian insufficiency. N Engl J Med. 2009;360(6):606–614.
Welt CK Primary ovarian insufficiency: a more accurate term for premature ovarian failure. Clin Endocrinol (Oxf). 2008;68(4):499–509.
De Vos M. et al. Primary ovarian insufficiency. Lancet. 2010;376(9744):911–921.
La Marca A., Broekmans FJ et al. Anti-Mullerian hormone (AMH) as a diagnostic tool in reproductive medicine. Hum Reprod Update. 2009;15(5):465–481.
Kawamura K., Kawamura N. et al. Hippo signaling disruption and Akt stimulation of ovarian follicles for infertility treatment. Proc Natl Acad Sci USA. 2013;110(43): 17474–17479 .
Oktay K., Turan V. et al. Fertility preservation in women with POI. Trends Mol Med. 2016;22(6):463–471.
Donnez J., Dolmans MM Transplantation of ovarian tissue. Best Pract Res Clin Obstet Gynaecol. 2020;65:109–117.
Wood-Trageser MA, Goswami D. et al. Genetic diagnosis in primary ovarian insufficiency. Fertil Steril. 2014;101(2):342–348.
