title: Long-term outcome of ovarian function in women with intermittent premature ovarian insufficiency.
abstract: BACKGROUND
  Spontaneous resumption of ovarian function is not a rare phenomenon in patients with premature ovarian insufficiency (POI). The outcome of this resumption is not known.
  
  
  OBJECTIVE
  To describe the outcome following the resumption of ovarian function in POI patients.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  University medical centre.
  
  
  METHODS
  Cumulative incidence of ovarian function resumption and risk factors arresting this resumption during follow-up were determined in a large cohort of POI women.
  
  
  RESULTS
  Five hundred and seven patients were included in the study, with a follow-up of 3·44 ± 4·05 years (0-29). Of these, 117 (23%) had features of ovarian function resumption. The cumulative incidence of pregnancy was 3·5% among the whole cohort and 15·3% among patients with resumption of ovarian function. Fifty-five patients (47%) experienced an arrest of their resumption during the follow-up period. In univariate analysis, high FSH and DHEA levels at initial evaluation were risk factors for the arrest of the resumption of ovarian function. In multivariate analysis, high FSH levels at the initial evaluation [1·89 (1·10-3·23), P = 0·03] and older age at diagnosis [1·53 (1·01-2·33), P = 0·04] were risk factors for the arrest of this resumption.
  
  
  CONCLUSIONS
  Resumption of ovarian function is not a rare or brief phenomenon in POI women. The identification of predictive factors of this resumption, as well as its duration, increases our knowledge of the natural history of POI, and will improve the medical management, especially infertility counselling of these patients.
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine and Centre de Référence des Maladies Endocriniennes Rares de la croissance et Centre des Pathologies gynécologiques Rares, ICAN, Paris, France.|UPMC Univ Paris 06, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Bachelot
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine and Centre de Référence des Maladies Endocriniennes Rares de la croissance et Centre des Pathologies gynécologiques Rares, ICAN, Paris, France.|UPMC Univ Paris 06, Paris, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Nicolas
authors.affiliation: AP-HP, Department of Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Maladies Endocriniennes Rares de la Croissance et Centre des pathologies gynécologiques Rares, Hôpital Universitaire Necker Enfants malades, Paris, France.
authors.forename: Maud
authors.initials: M
authors.lastname: Bidet
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine and Centre de Référence des Maladies Endocriniennes Rares de la croissance et Centre des Pathologies gynécologiques Rares, ICAN, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Dulon
authors.affiliation: AP-HP, Hôpital Pitié-Salpêtrière, Department of Hormonal Biochemistry, Paris, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Leban
authors.affiliation: UPMC Univ Paris 06, Paris, France.|AP-HP, Hôpital Pitié-Salpêtrière, Clinical Research Unit, Paris, France.
authors.forename: Jean Louis
authors.initials: JL
authors.lastname: Golmard
authors.affiliation: AP-HP, Department of Pediatric Endocrinology, Gynecology and Diabetology, Centre de Référence des Maladies Endocriniennes Rares de la Croissance et Centre des pathologies gynécologiques Rares, Hôpital Universitaire Necker Enfants malades, Paris, France.|Université Paris Descartes, Paris 05, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Polak
authors.affiliation: AP-HP, IE3M, Hôpital Pitié-Salpêtrière, Department of Endocrinology and Reproductive Medicine and Centre de Référence des Maladies Endocriniennes Rares de la croissance et Centre des Pathologies gynécologiques Rares, ICAN, Paris, France.|UPMC Univ Paris 06, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Touraine
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003687:Dehydroepiandrosterone / Q000097:blood; D005260:Female; D005298:Fertility; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D010053:Ovary / Q000502:physiology / Q000503:physiopathology*; D011247:Pregnancy; D016649:Primary Ovarian Insufficiency / Q000503:physiopathology*; D011379:Prognosis; D055815:Young Adult
chemical_list: D003687:Dehydroepiandrosterone; D005640:Follicle Stimulating Hormone