Premature ovarian failure (POF) is loss of ovary function before the age of 40 years. Failing ovaries do not produce adequate hormones, so eggs are not released regularly and infertility occurs. Premature ovarian failure is different from premature menopause. Women with early menopause stop having periods altogether, and the woman cannot become pregnant. With premature ovarian failure, pregnancy is possible. Between 5-10% of women with premature ovarian failure go on to get pregnant without medical intervention, but others require treatment.
What are the symptoms of premature ovarian failure?
A woman experiencing premature ovarian failure will experience certain symptoms. These include:
- Night sweats
- Irregular or missed periods
- Hot flashes
- Vaginal dryness
- Decreased sexual desire
- Difficulty concentrating
What causes premature ovarian failure?
Premature ovarian failure is the result of either follicle dysfunction or follicle depletion. With normal fertilization, the pituitary gland releases hormones that cause the ovaries’ egg-containing follicles to mature. When one follicle reaches maturity, it bursts open and releases an egg into the fallopian tube. With follicle depletion, the number of follicles in the ovary that may mature are less than should be, due to toxins or chromosomal defects. Follicle dysfunction occurs when the follicle does not mature due to an autoimmune disease or other factors.
How is premature ovarian failure treated?
The main treatment for premature ovarian failure is estrogen replacement therapy. Estrogen is prescribed along with progesterone, which protects the uterus lining. The combination of these hormones may restore ovarian function.
- Estrogens – These are available in pill form, as a gel or patch applied to the skin, or as a vaginal ring that can be replaced every 3 months. The doses is 100-150 mcg daily for transdermal (topical), and estradiol 2-4 mg daily for oral form.
- Progestins – These are administered only 10-14 days each month, with recommended dose of medroxyprogesterone 10 mg orally.
- Androgens – Many women also have low levels of free testosterone, which can cause low libido and fatigue. Methyltestosterone is given in 1.25-2.5 mg each day orally.
- LHRHa – Luteinizing hormone-release hormone analogue can be used during chemotherapy to protect the ovaries. LHRHa reduces the risk of ovarian failure and is associated with a higher pregnancy rate for cancer patients who take it. The rates of premature ovarian failure are reduced two-thirds in patients who take LHRHa, according to clinical studies.
- DHEA – Supplementation with DHEA has shown positive results in some studies of women with ovarian insufficiency. However, it is less effective for women with outright ovarian failure.
Can premature ovarian failure be predicted?
With new technology and scientific research, there are now ways the Dubai fertility doctor can detect if you are at risk for developing POF. The FMR1 genotype tests for a gene that predicts whether or not a woman will have POF. Women diagnosed with high risk for future POF can managed their reproductive life by freezing eggs.
At PRC Fertility Center in Dubai, comprehensive fertility treatments are offered. This includes first rate Dubai IVF treatments, egg freezing, ICSI and additional options to help women reach their fertility goals. Call us today!