b.早期卵巣不全(1.内分泌)

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Premature ovarian failure (POF) is clinically defined by the triad of amenorrhea, elevated gonadotropin and hypoestrinism in women younger than age 40 (35). The incidence of POF is reported to be 1 in 100 by age 40 and 1 in 1, 000 by age 30. POF is not uncommon but, it remains very difficult to induce ovulation and conception in these cases, even though there have been many studies on the treatment of patients with POF. POF was first considered irreversible on the basis of early studies, and was associated with permanent sterility because of the absence of primordial follicles. But, de Morase-Ruehsen and Jones reported that there are patients with follicles as a "the resistant ovary syndrome" in those clinically diagnosed with POF. In addition, successful pregnancies have been reported in patients diagnosed with POF or premature menopause on the basis of histologic finding in the ovaries. So, "premature ovarian dysfunction" may be a more suitable of the disease. POF may occur due to genetic factors, autoimmune disorders, destruction of the ovaries by iatrogenic factors or unknown factors. There are particularly interesting immunologic studies on patients with POF : (1) the association of other autoimmune disorders, (2) the demonstration of circulating antibodies to ovarian tissue in sera of women with this disorder, and (3) the histologic finding of a lympocytic infiltrate within ovaries of some patents with POF. The use of fertility durgs, such as clomiphene citrate or human menopausal gonadotropins, to stimulate the ovaries is unsuccessful. The literature contains reports of successful therapy in the restoration of ovulation and pregnancies in patient with POF by using glucocorticoid, estrogen (pill, hormone replacement therapy), gonadotopin releasing hormone agonist and assisted reproductive technology with donor eggs. It is important to counsel patients about the possible intermittent return of ovarian function and the 5%〜10% chance of pregnancy. The definition, etiologic factors, classification, diagnosis and treatment of POF have not been established. In this paper, it's etiologic factors, classification, diagnosis and treatment were reviewed.
社団法人日本産科婦人科学会の論文
2000-08-01

b.早期卵巣不全(1.内分泌)

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