Treatment of premature ovarian failure with a new method

Premature ovarian failure(POF) also named as primary ovarian insufficiency(POI) is the cessation of ovarian function, that affects women under the age of 40-years-old. For the first time POF was described as a non-physiological amenorrhea before theage of 40 years but after puberty, by Moraes-Ruehsen and Jones in 1967 (2). Most of POF cases refer to a gynecologist because of experiencing secondary amenorrhea or facing problem in getting pregnant. POF is not a rare condition and it characterized by 4-6 months of amenorrhea .The prevalence of POF is 0/5-3% in childbearing age and it develops in 1% of women under the age of 40 and 0/1% of women under the age of 30 and 0/01% of women under the age of 20. In most cases the cause of POF is unknown (4) but known causes can be classified as primary such as genetics, enzyme deficiency, autoimmune diseases and secondary such as surgical, chemotherapy or radiotherapy, infection (5) but as said in a review article genetics and especially X chromosome abnormalities are the underlying cause of POF (6); also Portoni et al. (7) found abnormality in karyotype of 8.8% of 90 cases with diagnosed POF(8). some cases of POF are syndromic like Turner’s syndrome or blepharophimosis-ptosis-epicanthus inversus syndrome(BPES) .The health condition of Women with POF is associated with sex steroid hormone deficiency(hypoestrogenism), amenorrhea, a rise in serum gonadotropins like FSH greater than 40mIU/L . POF may enhance the risk of osteoporosis ,infertility and ischemic heart disease.The treatment of POF was done specially for 2 reasons ;suppress impaired functions of ovaries and avoid early infertility .Hormone replacement therapy(HRT) is used for the first purpose and fertility preservation is performed for the second one. Discussing treatments for women with POF, hormone replacement therapy (HRT) is the most known treatment which is applied as a continuous estrogen and progestogen replacement (5). In the case discussed in this report no chromosome abnormality was found in the cytogenetic examination and by ruling out other possible causes by proper tests, the case was diagnosed with an idiopathic POF. In this case, a novel medication was applied to the patient including coenzyme Q10, Inofolic, and dehydroepiandrosterone (DHEA). DHEA as a part of this medication and also its supplements are reported to have a beneficial effect in POF patients as it increases the chance of pregnancy and also makes IVF procedure more successful (1). Our patient had undergone this treatment before she presented herself to her gynecologist complaining of having menopausal complications. After scanning her Para clinical tests, surprisingly her pregnancy was approved and till the 8th month of her pregnancy, she and her fetus were in complete health.