Endocrine Abstracts

Context: Early premature ovarian failure (ePOF) defined by cessation of ovarian function before age 18 is a rare condition. The link between puberty progression and POF hasn’t been explored in details.

Aim of study: To describe pubertal development and clinical practices of women with ePOF in a referral center for RME within the first 2 years follow-up.

Description method/design: A mixed retrospective and prospective study was performed. A total of 358 consecutive POF patients were followed from 1997 to 2010. From this cohort 108 patients with ePOF (young girls, adolescents <18 years of age at diagnosis of POF) with karoytype excluding Turner syndrome, and no iatrogenic cause are the focus of our study.

Their clinical (age, pubertal evolution, circumstance diagnosis), hormonal (FSH, LH, E₂) and morphological features (pelvic ultrasonography, laparoscopy) were analyzed. We also documented their management’s characteristics (type of/age of hormonal treatment).

Results: Primary amenorrhea (PA) was more often associated with Tanner breast’s stage 1–2–3 and delayed or partial puberty (28.7%) than breast’s stage 5 and normal puberty (12%). Secondary amenorrhea (SA) was associated to stage 5 and normal puberty (27.7%). SA’s mean age was 16.22 (15–18) years with menarchy at 13.56 (10.5–17) years. The diagnoses are made on high FSH and mean level was 94.76 UI/l. LH was 32 UI/l and estradiol 17 ng/ml.

Mean age at start of hormonal treatment was 17.55 (15–28) years; progestogen’s onset was one year later. Combined treatment started at 18 years old. During these two years 1/5 of patients were lost for follow-up.

Conclusion: The fact to complete puberty doesn’t exclude PA. However in SA a normal puberty is most often found then in PA. Suboptimal care of these ePOF is documented therefore widespread guidelines to improve care of patients with early POF are needed.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This work was supported, however funding details unavailable.