Gossain V V, Carella M J, Rovner D R
Department of Medicine, Michigan State University, East Lansing 48824.
J Med. 1993;24(6):393-402.
Spontaneous pregnancy in patients with premature ovarian failure, although previously reported, remains quite rare. We report a patient with premature ovarian failure who spontaneously conceived and carried the pregnancy to full term. A 26 year old, white female with primary hypothyroidism (diagnosed in 1979) was first seen by us in January 1984 for secondary amenorrhea of six months duration. Menarche occurred at age 13 and menstrual periods were regular until May 1983. She experienced hot flashes in the summer of 1983, and also complained of dryness in her vagina. Serum estrogens were low, and serum gonadotropins were elevated. Physical exam was within normal limits except for a slight, diffuse enlargement of the thyroid gland. Antithyroglobulin and anti-microsomal antibodies were positive. She was clinically and bio-chemically euthyroid while taking exogenous L-thyroxine. A diagnosis of premature ovarian failure was, therefore, made. Therapy was initiated with Premarin and Provera, and she began to have regular withdrawal bleeding. In February 1991, she presented to her obstetrician stating that she was pregnant. The course of the pregnancy was uncomplicated. A cesarean section was performed at 40.5 weeks gestation and she delivered a live female infant. This case confirms that, although rare, patients with premature ovarian failure may spontaneously ovulate and conceive. The course of pregnancy in patients with ovarian failure appears to be normal.
卵巢早衰患者自然受孕，尽管此前有过报道，但仍然相当罕见。我们报告一例卵巢早衰患者自然受孕并足月分娩。一名26岁的白人女性，患有原发性甲状腺功能减退（1979年确诊），1984年1月因持续6个月的继发性闭经首次前来就诊。月经初潮于13岁出现，月经周期一直规律，直到1983年5月。她在1983年夏天出现潮热，还抱怨阴道干涩。血清雌激素水平低，血清促性腺激素水平升高。体格检查除甲状腺稍有弥漫性肿大外均在正常范围内。抗甲状腺球蛋白和抗微粒体抗体呈阳性。她在服用外源性左甲状腺素时临床和生化指标均处于甲状腺功能正常状态。因此，诊断为卵巢早衰。开始用普瑞马林和安宫黄体酮进行治疗，她开始有规律的撤退性出血。1991年2月，她告知产科医生自己怀孕了。孕期过程无并发症。妊娠40.5周时行剖宫产，她产下一名活女婴。该病例证实，尽管罕见，但卵巢早衰患者可能自然排卵并受孕。卵巢早衰患者的孕期过程似乎是正常的。
