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Routine endocrine screening for patients with karyotypically normal spontaneous premature ovarian failure
T J Kim1, J N Anasti, M R Flack
1Section on Women's Health, Developmental Endocrinology Branch, National Institute of Child Health and Human Development, Bethesda, Maryland, USA.
Obstetrics and Gynecology
|May 1, 1997
Summary
Routine screening for hypothyroidism and diabetes is recommended for women with spontaneous premature ovarian failure who desire fertility. However, testing for other autoimmune endocrine disorders should be based on clinical indications.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Autoimmune Diseases
Background:
- Spontaneous premature ovarian failure (POF) is a condition affecting women of reproductive age.
- Associated autoimmune endocrine disorders can impact fertility and overall health.
- Karyotypically normal POF requires evaluation for co-existing conditions.
Purpose of the Study:
- To assess the utility of routine screening for associated autoimmune endocrine disorders in women with karyotypically normal spontaneous POF.
- To determine the prevalence of specific endocrine conditions in this patient population.
Main Methods:
- A cohort of 119 women with karyotypically normal spontaneous POF was evaluated.
- Screening included physical examination, thyroid function tests (thyroxine, TSH), ACTH stimulation test, glucose tolerance tests, and electrolyte/vitamin B12 measurements.
Main Results:
- 18.5% of patients had pre-existing hypothyroidism or Addison disease.
- New diagnoses included 10 cases of hypothyroidism and 3 of diabetes mellitus.
- No new cases of adrenal insufficiency, hypoparathyroidism, or pernicious anemia were identified.
Conclusions:
- Screening for hypothyroidism and diabetes mellitus is clinically justified in women with karyotypically normal spontaneous POF desiring fertility.
- Testing for other autoimmune endocrine disorders in these patients may be reserved for cases with specific clinical symptoms.