Curr Opin Obstet Gynecol. 2013 Oct;25(5):375-81. doi: 10.1097/GCO.0b013e328364ed2a.
To raise awareness about the importance of early diagnosis of primary ovarian insufficiency (POI) in the adolescent.
Menstrual cycle irregularity or amenorrhea in the adolescent has historically been treated with oral contraceptives or ignored, with no evaluation done to determine the cause. However, it is now becoming clear that the health consequences of menstrual irregularities differ depending on the cause, and evaluation to determine the cause of menstrual irregularity is warranted. Although POI is classically diagnosed when menstrual cycle irregularity is accompanied by high circulating levels of gonadotropins and low estradiol, anti-Mullerian hormone is emerging as a biomarker of increasing importance. When POI is diagnosed, further evaluation including karyotype, FMR1 premutation analysis, and 21-hydroxylase or adrenal antibody is warranted. Girls at high risk for the development of POI (e.g. because of planned cancer treatment) should be offered the option of oocyte or ovarian tissue cryopreservation.
POI should be ruled out in adolescents with menstrual cycle irregularity. Early diagnosis of POI facilitates the individualization of therapy, as the health consequences of POI differ from those of other causes of menstrual cycle irregularity. In addition, recognition of premature oocyte depletion allows for the option of fertility preservation to be discussed when oocytes are still present.
提高对青少年原发性卵巢功能不全（POI）早期诊断重要性的认识。
青少年的月经周期不规律或闭经在过去一直采用口服避孕药治疗或不予理会，没有进行评估以确定病因。然而，现在很明显，月经不规律的健康后果因病因而异，有必要进行评估以确定月经不规律的病因。尽管当月经周期不规律伴有高循环水平的促性腺激素和低雌二醇时，经典地诊断为 POI，但抗苗勒管激素作为一种越来越重要的生物标志物正在出现。当诊断为 POI 时，需要进行进一步评估，包括核型、脆性 X 综合征前突变分析、21-羟化酶或肾上腺抗体。有发生 POI 高风险的女孩（例如，因为计划进行癌症治疗）应提供卵母细胞或卵巢组织冷冻保存的选择。
对于月经周期不规律的青少年，应排除 POI。POI 的早期诊断有助于个体化治疗，因为 POI 的健康后果与其他月经周期不规律的病因不同。此外，认识到卵母细胞的过早耗竭，可以在仍有卵母细胞时讨论生育力保存的选择。
