Premature ovarian insufficiency (POI) and autoimmunity-an update appraisal

Michal Kirshenbaum, Raoul Orvieto

Research output: Contribution to journalReview articlepeer-review

47 Scopus citations

Abstract

Purpose: Primary ovarian insufficiency (POI) represents ovarian dysfunction related to very early aging of the ovaries. While the cause of POI in a majority of clinical cases remains undefined, autoimmunity is responsible for approximately 4–30% of POI cases. In the present paper, we aim to provide a critical appraisal and update review on the role of autoimmunity in POI patients. Methods: A literature review was conducted for all relevant articles reporting on POI and autoimmunity. PubMed/MEDLINE and the Cochrane library were searched for the best available evidence on this topic. Results: Patients with POI and coexisting autoimmunity are indistinguishable from those with negative autoimmune screen with regard to age of onset, prevalence of primary amenorrhea, or their endocrine profiles. A specific noninvasive reliable diagnostic test for the diagnosis of an autoimmune etiology is lacking; therefore, patients should be screened for the most common autoantibodies, i.e., steroid cell antibodies, anti-ovarian antibodies, and anti-thyroid antibodies. Moreover, treatment strategies to POI infertility are lacking and controversial. Conclusions: Nowadays, guidelines for the treatment of autoimmune POI are not available. Moreover, since diagnostic and treatment strategies to POI infertility are still lacking and controversial, further large clinical studies are needed to investigate the true impact of autoimmunity on POI and to identify the selected groups of patients who are most likely to benefit from immunossuprresive treatment.

Original languageEnglish
Pages (from-to)2207-2215
Number of pages9
JournalJournal of Assisted Reproduction and Genetics
Volume36
Issue number11
DOIs
StatePublished - 1 Nov 2019
Externally publishedYes

Keywords

  • Anti-ovarian antibodies
  • Anti-thyroid antibodies
  • Autoimmunity
  • Diagnosis
  • Immunossuprresive
  • Primary ovarian insufficiency (POI)
  • Steroid cell antibodies

ASJC Scopus subject areas

  • Reproductive Medicine
  • Genetics
  • Obstetrics and Gynecology
  • Developmental Biology
  • Genetics(clinical)

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