Premature Ovarian Failure - An Unusual Manifestation of Systemic Sclerosis

A 31-year-old woman presented with secondary amenorrhoea and inability to conceive, which was of 3 years duration. She had Raynaud's phenomenon for 16 years, primary hypothyroidism for 5 years, digital ulcers for 4 years and skin tightening for 2 years. She had an expressionless face, with loss of wrinkles and restriction of the mouth opening along with flexion contractures of the hands and the terminal digit resorptions. Investigations showed Antinuclear antibodies (ANA) and anti-Scl 70 positivity confirming the presence of systemic sclerosis (SSc). The Follicle Stimulating Hormone (FSH) level was elevated, the ovarian follicles were absent, and the endometrial thickness was reduced confirming premature ovarian failure (POF). POF causing infertility and secondary amenorrhoea in SSc is an unusual manifestation; moreover, POF occured without the involvement of other internal organs.