Hydrocortisone as a Potential Treatment of Savage Ovary Syndrome: A Rare Case from Syria

Abstract

A 32-year old woman with a secondary amenorrhea for 5 years presented to my clinic (April 2019), previously had been treated as a premature ovarian failure patient and put on HRT. With further investigation, FSH Levels were high at the menopausal range, whereas the AMH levels and antral follicles count were within normal ranges and found to be age-compatible, These findings, as well as the failure of ovaries to respond to exogenous gonadotropins, helped to set the diagnosis of Savage Ovary Syndrome, which is also known as Insensitive Ovary Syndrome (IOS). Written informed consent was obtained from the patient for publication of this case report and accompanying images" Patient was convinced to be treated empirically with a high dose of Hydrocortisone and the result was the patient well responded as a normal spontaneous menstruation happened. The analysis of FSH and estradiol induces normal values and the return of the functional activity of the ovary to the formation of multiple ovarian bilateral follicle and give an echo feature similar to the ovarian hyper stimulatory syndrome with an increase the thickness of the endometrium. This case shows the importance of further studying patients with secondary amenorrhea and high levels of gonadotropins and not to treat them all as premature ovary insufficiency patients, just like our patient was firstly treated for a long time. Furthermore, the case highlights the potential benefit of the treatment of Savage Ovary Syndrome patients with Hydrocortisone.