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12:03
Fertility Preservation in Patients with Severe Ovarian Dysfunction
Published on: March 25, 2021
Primary ovarian insufficiency: autoimmune causes
Antonio La Marca1, Annalisa Brozzetti, Giovanna Sighinolfi
1Mother-Infant Department, Section of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy.
Current Opinion in Obstetrics & Gynecology
|June 15, 2010
Summary
Steroid cell autoimmunity causes premature ovarian insufficiency (POI) by destroying theca cells. Early diagnosis using autoantibodies and ovarian reserve markers like AMH can identify preserved follicles for potential future fertility treatments.
Area of Science:
- Reproductive Endocrinology
- Immunology
- Gynecologic Pathology
Background:
- Premature ovarian insufficiency (POI) is a heterogeneous condition.
- Steroid cell autoimmunity (SCA-POI) is a specific autoimmune cause of POI.
- Understanding SCA-POI pathogenesis is crucial for diagnosis and management.
Purpose of the Study:
- To review the pathogenesis of premature ovarian insufficiency (POI) resulting from steroid cell autoimmunity (SCA-POI).
Main Methods:
- Review of literature on autoimmune oophoritis and SCA-POI.
- Analysis of characteristic histopathological findings in autoimmune oophoritis.
- Evaluation of hormonal and ovarian reserve markers in SCA-POI.
Main Results:
- Autoimmune oophoritis involves selective mononuclear cell infiltration of the theca layer in large follicles.
- SCA-POI results from autoimmune destruction of theca cells, sparing granulosa cells.
- Elevated inhibin levels are typical; normal AMH is observed in many with recent SCA-POI, indicating preserved follicles.
Conclusions:
- Combined autoantibody and ovarian reserve marker (inhibin B, AMH) testing aids in identifying SCA-POI with preserved follicles.
- Future in-vitro folliculogenesis techniques may offer new therapeutic options for SCA-POI-related infertility.
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