Ovarian Failure

Question 1

what is it?

Answer 1

• 5% of ovulatory disorders
• High levels of gonadotrophins
• Low oestrogen levels
• Can be caused by resistant ovary (caused by functional disturbance of the gonadotropin receptors in the ovarian follicles)
• Amenorrhoea
• Menopausal

Question 2

what is premature ovarian failure?

Answer 2

menopause before 40

Question 3

how is premature ovarian failure managed?

Answer 3

HRT,
egg/embryo donation (assisted conception treatment),
ovary/egg/embryo cryopreservation prior to radio/chemotherapy where POF is anticipated,
counselling

Question 4

gynaecological history of premature ovarian failure

Answer 4

amenorrhoea 
hirsutism 
galactorrhoea 
headaches 
visual symptoms

Question 5

what is the biochemistry investigation of premature ovarian failure

Answer 5

mid luteal progesterone [day 21],
biochemistry of early follicular phase [day 2-5],
progesterone challenge test (menstrual bleed in response to a five day course of progesterone indicates oestrogen levels are normal)

Question 6

other investigations for premature ovarian failure?

Answer 6

Ultrasound (transvaginal, pelvis)
Scans to look for follicular growth/monitor ovulation induction
Karyotype
Auto antibody screen MRI of pituitary fossa
Bone density scan