title: Resumption of ovarian function and pregnancies in 358 patients with premature ovarian failure.
abstract: BACKGROUND
  Resumption of ovarian activity and spontaneous pregnancies are described in patients with premature ovarian failure (POF), but there is a lack of data concerning the prevalence of and predictive factors for these phenomena.
  
  
  OBJECTIVE
  The aim of the study was to determine both the prevalence of and predictive factors for spontaneous resumption of ovarian function in POF patients.
  
  
  METHODS
  A mixed retrospective and prospective study was performed at a referral center for reproductive endocrinology.
  
  
  METHODS
  A total of 358 consecutive POF patients were followed from 1997 to 2010 in our center.
  
  
  METHODS
  The cumulative incidence of resumption of ovarian function was determined, and predictive factors were identified by univariate and multivariate analysis.
  
  
  RESULTS
  Of 358 patients with idiopathic POF, 86 (24%) patients presented features indicating resumption of ovarian function, and in 77 cases (88%) within 1 yr of diagnosis. Twenty-one spontaneous pregnancies (16 births, five miscarriages) occurred in 15 (4.4%) patients. Multivariate analysis (Cox model) showed that a familial history of POF, secondary amenorrhea, presence of follicles at ultrasound, and inhibin B and estradiol levels were significantly predictive of resumption of ovarian function (P < 0.01), whereas association with an autoimmune disease, anti-mullerian hormone level, the presence of follicles on biopsy, and/or genetic abnormalities did not appear predictive. We created a predictive score for resumption of ovarian function comprising age at diagnosis, presence of follicles at ultrasound, and inhibin B level.
  
  
  CONCLUSIONS
  Intermittent ovarian activity in patients with POF is not a rare phenomenon. The predictive score described in this study may help us to identify POF patients most likely to recover intermittent ovarian function.
authors: Department of Endocrinology and Reproductive Medicine, Groupe Hospitalier Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris Cedex 13, France.
authors: Maud
authors: M
authors: Bidet
authors: Anne
authors: A
authors: Bachelot
authors: Estelle
authors: E
authors: Bissauge
authors: Jean Louis
authors: JL
authors: Golmard
authors: Solenne
authors: S
authors: Gricourt
authors: Jérôme
authors: J
authors: Dulon
authors: Christiane
authors: C
authors: Coussieu
authors: Yasmina
authors: Y
authors: Badachi
authors: Philippe
authors: P
authors: Touraine
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007265:Inhibins / Q000097:blood; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000502:physiology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D016649:Primary Ovarian Insufficiency / Q000097:blood / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology*; D013739:Testosterone / Q000097:blood
chemical_list: C422364:inhibin B; D013739:Testosterone; D004958:Estradiol; D007265:Inhibins; D054304:Anti-Mullerian Hormone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone