Do etiologies of premature ovarian aging (POA) mimic those of premature ovarian failure (POF)?
BACKGROUND
It is unknown whether etiologies differ between milder forms of premature ovarian senescence (the acronym given here 'premature ovarian aging, POA'), and premature ovarian failure (POF).


METHODS
We assessed presumed pathophysiologies in 74 consecutive POA patients, diagnosed based on elevated age-specific baseline follicle stimulating hormone and/or abnormally low anti-Müllerian hormone levels (<1.5 ng/ml). A genetic etiology was presumed with > or = 34 triple CGG expansions on the FMR1 gene. An autoimmune etiology was assumed with at least one abnormality in a laboratory panel, involving antinuclear, antiphospholipid and thyroid antibodies, total immunoglobulin levels and anti-ovarian as well as anti-adrenal autoantibodies. A combined etiology was presumed with both autoimmune and genetic etiologies, and a patient was considered idiopathic when no abnormalities were found.


RESULTS
Twelve of 74 (16.2%) women demonstrated a genetic, 28 (37.8%) an autoimmune, 9 (12.2%) combined and 25 (33.8%) idiopathic etiologies.


CONCLUSIONS
Presumed underlying etiologies with POA follow a similar distribution pattern as reported for POF. POA and POF may, therefore, represent a continuum in phenotypical expression of different etiologies of premature ovarian senescence. Like POF, POA should be considered reason to investigate underlying etiologies.
Gleicher
Norbert
N
Center for Human Reproduction, 21 East 69th Street, New York, NY 10021, USA. ngleicher@thechr.com
Weghofer
Andrea
A
Oktay
Kutluk
K
Barad
David
D
D000328:Adult; D000367:Age Factors; D054304:Anti-Mullerian Hormone / Q000097:blood; D015331:Cohort Studies; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D051860:Fragile X Messenger Ribonucleoprotein 1 / Q000235:genetics; D006801:Humans; D010049:Ovarian Diseases / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D016649:Primary Ovarian Insufficiency / Q000209:etiology* / Q000235:genetics / Q000503:physiopathology; D019680:Trinucleotide Repeat Expansion
D054304:Anti-Mullerian Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone; D051860:Fragile X Messenger Ribonucleoprotein 1; C497683:FMR1 protein, human