Hormone Replacement Therapy and fertility options in a patient with Premature Ovarian Insufficiency

2019 ◽  
Author(s):  
Raya Almazrouei ◽  
Channa Jayasena
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency

REPRODUCTIVE POTENTIAL OF WOMEN WITH PREMATURE OVARIAN INSUFFICIENCY

2021 ◽  
pp. 41-48
Author(s):  
Spiridenko G.Yu. ◽  
Petrov Yu.A. ◽  
Palieva N.V.
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Assisted Reproductive Technologies ◽  
Hormone Replacement ◽  
Reproductive Potential ◽  
Reproductive Technologies ◽  
Pathological Process ◽  
Reproductive Age ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency

Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.

scholarly journals Hormone Replacement Therapy Reverses Gut Microbiome and Serum Metabolome Alterations in Premature Ovarian Insufficiency

2021 ◽  
Vol 12 ◽  
Author(s):  
Lingling Jiang ◽  
Haiyi Fei ◽  
Jinfei Tong ◽  
Jiena Zhou ◽  
Jiajuan Zhu ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Gut Microbiota ◽  
Replacement Therapy ◽  
Gut Microbiome ◽  
Hormone Replacement ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Serum Metabolites ◽  
Tgf Β1 ◽  
Metabolic Signatures

ObjectiveWe explored the gut microbiome and serum metabolome alterations in patients with premature ovarian insufficiency (POI) and the effects of hormone replacement therapy (HRT) with the aim to unravel the pathological mechanism underlying POI.MethodsFecal and serum samples obtained from healthy females (HC, n = 10) and patients with POI treated with (n = 10) or without (n = 10) HRT were analyzed using 16S rRNA gene sequencing and untargeted metabolomics analysis, respectively. Peripheral blood samples were collected to detect serum hormone and cytokine levels. Spearman’s rank correlation was used to evaluate correlations between sex hormones and cytokines and between the gut microbiota and serum metabolites. To further confirm the correlation between Eggerthella and ovarian fibrosis, the mice were inoculated with Eggerthella lenta (E. lenta) through oral gavage.ResultsThe abundance of genus Eggerthella significantly increased in the fecal samples of patients with POI compared to that observed in the samples of HCs. This increase was reversed in patients with POI treated with HRT. Patients with POI showed significantly altered serum metabolic signatures and increased serum TGF-β1 levels; this increase was reversed by HRT. The abundance of Eggerthella was positively correlated with altered metabolic signatures, which were, in turn, positively correlated with serum TGF-β1 levels in all subjects. Estrogen ameliorated ovarian fibrosis induced by E. lenta in mice.ConclusionsThe interactions between the gut microbiota, serum metabolites, and serum TGF-β1 in patients with POI may play a critical role in the development of POI. HRT not only closely mimicked normal ovarian hormone production in patients with POI but also attenuated gut microbiota dysbiosis and imbalance in the levels of serum metabolites and TGF-β1, which are reportedly associated with fibrosis. The findings of this study may pave the way for the development of preventive and curative therapies for patients with POI.

scholarly journals Premature ovarian insufficiency – hormone replacement therapy and management of long-term consequences

2018 ◽  
Vol 17 (3) ◽  
pp. 135-138 ◽  
Author(s):  
Paulina Machura ◽  
Monika Grymowicz ◽  
Ewa Rudnicka ◽  
Wojciech Pięta ◽  
Anna Calik-Ksepka ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Long Term Consequences

Menopause

2021 ◽  
pp. 241-266
Author(s):  
Debra Holloway
Keyword(s):  
Hormone Replacement Therapy ◽  
Sexual Dysfunction ◽  
Replacement Therapy ◽  
Hormone Replacement ◽  
Ovarian Failure ◽  
Menstrual Period ◽  
Premature Ovarian Insufficiency ◽  
Last Menstrual Period ◽  
Ovarian Insufficiency ◽  
Abnormal Bleeding

Menopause is the permanent cessation of menstruation, caused by ovarian failure. It can only be diagnosed a year after the last menstrual period, and is therefore a retrospective event. This chapter covers the signs, investigations, and treatments available for menopause, including Hormone Replacement Therapy, alternatives, modes of delivery, and non-hormonal alternative options. Abnormal bleeding and sexual dysfunction at the menopause are also explained. It also covers premature ovarian insufficiency, and causes and treatments for this disorder.

scholarly journals Spontaneous pregnancy in a patient with premature ovarian insufficiency after a failed attempt of ovulation induction

2021 ◽  
Vol 10 (9) ◽  
pp. 3584
Author(s):  
Nasuha Yaacob ◽  
Fadzlin M. Adzlan ◽  
Siti Nabillah Ab Rahman
Keyword(s):  
Hormone Replacement Therapy ◽  
Menstrual Cycle ◽  
Caesarean Section ◽  
Ovulation Induction ◽  
Hormone Replacement ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Healthy Baby ◽  
Spontaneous Pregnancy ◽  
Failed Attempt

Premature ovarian insufficiency (POI) is defined as intermittent or permanent gonadal insufficiency before age of 40 years. POI causes female infertility hence pregnancies are uncommon but not impossible. Ovarian failure is not permanent, unlike menopause. There could be intermittent ovulation and spontaneous pregnancy. Many protocols aimed to restore ovarian functions have been described in the recent years. This is a case of POI women who conceived spontaneously in the immediate menstrual cycle after a failed attempt at ovarian stimulation following many years on hormone replacement therapy (HRT). She had an unremarkable pregnancy and delivered a healthy baby via caesarean section.

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