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30 de May, 2023

Premature Ovarian Failure and Fertility

In some cases, a woman's ovaries cease functioning before she reaches the age of 40. This condition is known as Premature Ovarian Failure (POF), early ovarian insufficiency, or early menopause, and women who suffer from it have fertility issues.

While there's no treatment to restore the normal functioning of the ovaries, in vitro fertilization with egg donation offers success rates of up to 85 percent for women who wish to become mothers.

Any fertility treatment should be accompanied by hormonal therapy with estrogen and progesterone.

This alleviates the menopausal symptoms of premature ovarian failure and helps prevent complications such as osteoporosis.

What is Premature Ovarian Failure?

Unlike men, who produce sperm throughout their lives, women are born with approximately 1 million eggs in their ovaries and do not generate new eggs.

80 percent of women deplete their ovarian reserve around the age of 45 or 50, leading to menopause. However, in some cases, a woman's ovaries stop functioning before she reaches 40.

This condition is known as premature ovarian failure, early ovarian insufficiency, or early menopause, and women who suffer from it face fertility issues.

Premature ovarian failure affects one in every hundred women of childbearing age and, in addition to causing the cessation of ovulation, it causes a decrease in the level of estrogen in the blood, which can increase the risk of osteoporosis.

Premature ovarian failure can be of two types:

  1. The ovaries stop working because they have run out of eggs.
  2. In 50 percent of women affected by premature ovarian failure, it is due to an ovulatory dysfunction in which the existing eggs do not respond to the body's hormonal stimuli

Main symptoms of premature ovarian failure

The symptoms of premature ovarian failure are usually similar to those of menopause:

  • Irregular menstrual periods that become increasingly sparse
  • Amenorrhea or absence of menstruation
  • Hot flashes
  • Night sweats
  • Insomnia
  • Vaginal dryness
  • Decreased libido
  • Pain during sexual intercourse
  • Loss of energy
  • Irritability and frequent mood swings
  • Difficulty concentrating
  • Infertility

Since women with premature ovarian failure have low levels of estrogen, they are more prone to developing osteoporosis and cardiovascular diseases.

How is premature ovarian failure diagnosed?

If you are under 40 and experience menstrual irregularities or any of the symptoms of premature ovarian failure, it is advisable to get a blood test between the third and fifth day of your menstrual cycle (if you are no longer menstruating, you can take the test any day) to determine if your ovaries are functioning correctly.

A high level of follicle-stimulating hormone (FSH) and a low level of estradiol are evidence of premature ovarian failure.

Once the diagnosis is obtained, your doctor is likely to repeat the test to confirm it and carry out some additional tests to determine the causes of premature ovarian failure.

Likewise, they will perform a gynecological vaginal ultrasound, which will allow them to confirm or rule out the presence of follicles in your ovaries.

Treatments to achieve pregnancy when suffering from premature ovarian failure

Although there is no fertility treatment to restore the normal functioning of the ovaries, in vitro fertilization with egg donation offers success rates of up to 85 percent for women who wish to become mothers.

It is essential for couples considering egg donation to feel comfortable with the decision. At Ingenes, we have an emotional support unit to accompany them in the process, as well as qualified personnel ready to answer any questions they may have.

woman-in-bed-Premature-ovarian-failure

In some cases where the woman still has a small ovarian reserve, it is possible to carry out an ovulation induction treatment followed by an in vitro fertilization cycle.

However, the ovaries' reaction is often insufficient, so you and your doctor should carefully evaluate this possibility before starting treatment.

If the woman is under 40 and there are no contraindications, any chosen treatment should be accompanied by hormonal therapy with estrogen and progesterone.

This alleviates the menopausal symptoms of premature ovarian failure and helps prevent complications such as osteoporosis.

Your doctor will ask you to take a low dose and gradually increase it until your hormonal levels return to normal.

Generally, hormonal therapy can be safely discontinued when a woman with premature ovarian failure reaches the natural age of menopause.

Treatment of premature ovarian failure should always be accompanied by advice for a healthy lifestyle to help decrease the risk of osteoporosis and heart disease.

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