Pregnancy following diagnosis of premature ovarian insufficiency: a systematic review

Fraison, Eloïse; Crawford, Giselle; Casper, Gabrielle R.; Harris, V. G.; Ledger, William

doi:10.1016/j.rbmo.2019.04.019

Cited by 72 publications

(61 citation statements)

References 80 publications

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“…As POI is a heterogeneous disease caused by different pathogenic mechanisms, it requires an individualized therapeutic strategy for each patient. Spontaneous ovulation and natural pregnancies in POI patients are very rare but still possible, especially for women aged below 30 (3,32). The current report provides one example of alternative therapy for POI patients, particularly of more advanced age, who wish to use autologous oocytes in IVF cycles.…”

Section: Discussionmentioning

confidence: 91%

Live Birth in Woman With Premature Ovarian Insufficiency Receiving Ovarian Administration of Platelet-Rich Plasma (PRP) in Combination With Gonadotropin: A Case Report

Hsu

et al. 2020

Front. Endocrinol.

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The conception rates among women with premature ovarian insufficiency (POI) remain extremely low. To achieve a successful pregnancy, most of these women have to receive donor oocytes through IVF treatment. Ovarian administration of platelet-rich plasma (PRP) has been recently applied to enhance the ovulatory function in women with poor ovarian response. However, no live birth has been reported for this application in patients with POI. In this study, we present a 37-year-old woman with POI who had secondary amenorrhea for 6 months. The clinical manifestations and evaluation of this women with a diminished ovarian function were an undetectable serum level of AMH (<0.02 ng/mL) and an elevated serum level of FSH (63.65 mIU/mL). A single dose of autologous PRP (extracted from 40 mL of peripheral blood) in combination with gonadotropin (150IU rFSH/75 IU rLH) was directly injected into the stroma of bilateral ovaries via vaginal sonographic guidance. Following the treatment, this patient received controlled ovarian stimulation and IVF during the successive months. Following embryo culture, three cleavage-stage embryos were transferred, leading to a successful pregnancy, which later resulted in the live birth of twins. This case report provides one example of alternative therapy that allows POI patients to use autologous oocytes in IVF treatment.

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Section: Discussionmentioning

confidence: 91%

Live Birth in Woman With Premature Ovarian Insufficiency Receiving Ovarian Administration of Platelet-Rich Plasma (PRP) in Combination With Gonadotropin: A Case Report

Hsu

et al. 2020

Front. Endocrinol.

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“…1). Although pregnancies in POI patients are very rare, physicians should keep in mind that the patients need to attempt pregnancy with their own oocytes, with or without success, before considering to egg donation, especially if the patient is young 7 . It remains, however, to be elucidated how young the patient should be, how long the couple should attempt pregnancy, and which treatment and management, except oocyte donation, is appropriate.…”

Section: Discussionmentioning

confidence: 99%

“…Pregnancies and live births are very rare in patients with POI, but it is believed that 5–10% of women with POI are able to achieve pregnancy and have a live birth, even after the diagnosis is established 1,2 . A number of treatment protocols for follicular development and ovulation induction have been investigated and validated in women with POI and desired fertility; however, thus far no treatment protocol has been shown to have superiority and approach the success rate of utilizing donor oocytes 1,6,7 . Therefore, the most practical alternatives for couples affected by POI to have a child are adoption or oocyte donation, the availability of which are extremely limited in Japan 8 .…”

Section: Introductionmentioning

confidence: 99%

“…The patient was informed of the very low pregnancy rate for POI patients, the lack of evidence‐based infertility treatment other than oocyte donation, and adoption as an alternative. The benefit and necessity of hormone replacement therapy (HRT), including estrogen and progestin therapy (EPT) to minimize bone loss and decrease the risk of cardiovascular events was explained 1,2,7 . Additionally, the case reports in the literature involving POI patients who spontaneously conceived on HRT/EPT 1,6,7 were discussed, including the authors' collective opinion that close follicle monitoring during HRT/EPT may increase the probability of pregnancy, 3,4 although the efficacy and validity of such management was unproven.…”

Section: Introductionmentioning

confidence: 99%

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A woman with primary ovarian insufficiency had two live births resulting from intrauterine inseminations during 10 years of ovarian follicle monitoring

Maruyama

2020

J of Obstet and Gynaecol

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Women with primary ovarian insufficiency rarely ovulate and even more rarely achieve a spontaneous pregnancy. A patient with primary ovarian insufficiency who had only 13 follicle development cycles during 13 years, but had 2 live births resulting from intrauterine inseminations is reported. She was diagnosed with primary ovarian insufficiency at 19 years of age and started infertility treatment at 23 years of age. During 10 of the 13 years that she was not pregnant and not breastfeeding, she underwent cyclic estrogen and progestin therapy with biweekly monitoring of follicle development. She delivered the first and second child at 30 and 37 years of age, respectively. This case report suggests that continuous follicle monitoring may increase the probability of having a child in a subset of patients with primary ovarian insufficiency and desired fertility, although the validity and efficacy of such management has not been established.

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“…There are no proven treatments to increase the rate of autologous oocyte pregnancies, as assessed by two systematic reviews published 20 years apart 132,133 . There have only been three RCTs of therapeutic interventions and all were small.…”

Section: Treatmentsmentioning

confidence: 99%

Premature ovarian insufficiency: an International Menopause Society White Paper

et al. 2020

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The aim of this International Menopause Society White Paper on premature ovarian insufficiency (POI) is to provide the latest information regarding this distressing condition. The impact of POI has far-reaching consequences due to its impact on general, psychological, and sexual quality of life, fertility prospects, and long-term bone, cardiovascular, and cognitive health. Progress in fully understanding the etiology, diagnosis, and optimal management options has been slow thus far due to the complexity of the condition and fragmented research. Recent advances in epidemiological and genetic research have improved our understanding of this condition and randomized prospective trials are being planned to determine the intervention strategies, which will optimize quality of life and long-term well-being. The International Menopause Society has commissioned a number of experts at the forefront of their specialty to define the state of the art in the understanding of this condition, to advise on practical management strategies, and to propose future research strategies. It is hoped that a global task force will subsequently be convened in order to formulate a consensus statement across key societies, to accelerate date collection and analysis of a global POI registry, and to facilitate progress in the key defined areas of research.

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Pregnancy following diagnosis of premature ovarian insufficiency: a systematic review

Cited by 72 publications

References 80 publications

Live Birth in Woman With Premature Ovarian Insufficiency Receiving Ovarian Administration of Platelet-Rich Plasma (PRP) in Combination With Gonadotropin: A Case Report

Live Birth in Woman With Premature Ovarian Insufficiency Receiving Ovarian Administration of Platelet-Rich Plasma (PRP) in Combination With Gonadotropin: A Case Report

A woman with primary ovarian insufficiency had two live births resulting from intrauterine inseminations during 10 years of ovarian follicle monitoring

Premature ovarian insufficiency: an International Menopause Society White Paper

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