Endocrine Abstracts

Introduction: Premature ovarian failure (POF) is defined as amenorrhea lasting more than four months before the age of 40 with a high level of gonadotropins in at least two separate samples. The aim of this work was to describe the etiological profile of a series of Tunisian women followed for POF.

Patients and methods: It is a descriptive study of 42 cases of POF collected in the endocrinology department of Sousse between 2000 and 2017.

Results: The average age of the patients was 23.85 years old. Thirty patients consulted for primary amenorrhea with an average age of 18.8 years and 12 patients consulted for secondary amenorrhea with an average age of 36.5 years. Eleven patients reported irregular periods before the installation of secondary amenorrhea while the beginning was brutal in the twelfth. A family history of primary sterility was found in two patients, a family autoimmunity field was found in two patients, whereas no history of early menopause was found in our patients. Nine patients were followed for type 1 diabetes, six patients for primary hypothyroidism and one patient for celiac disease. The hormonal profile showed an average FSH level of 90.7 mIU/ml, an average LH level of 49.82 mIU/ml and an average estradiol level of 21.42 pg/ml. The karyotype was requested in all patients who consulted for primary amenorrhea. It showed a mosaic Turner syndrome in two of our patients. In addition, the immunological survey showed positive anti-ovarian antibodies in one patient. At the end of this investigation, an autoimmun origin of POF was retained in 38% of patients and a genetic origin related to Turner syndrome in 4,76% of patients. The POF was idiopathic in 57,24% of our patients.

Discussion and conclusion: The POF is not an exceptional pathology. The most commun etiologies are at the present time sterilizing treatments such as chemotherapy or radiotherapy. Genetically, abnormalities of the X chromosome, in particular Turner syndrome, are identified. Most often, after a thorough clinical investigation, no etiology is found. Indeed, idiopathic POF still accounts for more than 75% of cases.