Shah D, Nagarajan N
Gynaecworld, The Center for Women's Health and Fertility, Mumbai, Maharashtra, India
Gynaecworld, The Center for Women's Health and Fertility, Mumbai, Maharashtra, India.
Post Reprod Health. 2014 Jun;20(2):62-68. doi: 10.1177/2053369114531909. Epub 2014 May 16.
Premature menopause is characterized by amenorrhea, elevated gonadotropin levels and sex steroid deficiency occurring in women below 40 years of age. Heterogeneity of premature ovarian failure is reflected by various causes, both spontaneous and iatrogenic. X chromosomal abnormalities remain the main cause of primary ovarian insufficiency. Women with primary ovarian insufficiency present with amenorrhea, irregular cycles, signs of estrogen deficiency and infertility. They are at increased risk for non-communicable diseases such as, cardiovascular disease, Alzheimer's disease, and osteoporosis. Management includes use of menopausal hormone therapy till the age of natural menopause and customized as per the needs. In women having fertility issues, IVF with donor oocytes remains the treatment of choice with the best results. With advances in assisted reproductive technologies, cryopreservation of oocytes/embryos should be utilized, whenever impending primary ovarian insufficiency is anticipated either due to therapy or biological reasons.
过早绝经的特征是闭经、促性腺激素水平升高以及40岁以下女性出现性类固醇缺乏。卵巢早衰的异质性体现在各种原因上，包括自发性和医源性原因。X染色体异常仍然是原发性卵巢功能不全的主要原因。原发性卵巢功能不全的女性表现为闭经、月经周期不规律、雌激素缺乏体征和不孕。她们患心血管疾病、阿尔茨海默病和骨质疏松症等非传染性疾病的风险增加。管理措施包括在自然绝经年龄之前使用绝经激素治疗，并根据需要进行定制。对于有生育问题的女性，使用供体卵母细胞的体外受精仍然是首选治疗方法，效果最佳。随着辅助生殖技术的进步，无论因治疗还是生物学原因预计即将出现原发性卵巢功能不全时，都应采用卵母细胞/胚胎冷冻保存技术。
