Primary Ovarian Insufficiency and its effect on fertility

What is the function of the ovaries?

The ovaries are oval-shaped organs located on either side of the uterus. Each ovary contains a woman's stock of eggs from birth. The primary function of the ovaries is to produce and store eggs. They are also responsible for producing hormones that regulate the menstrual cycle and are vital in facilitating pregnancy. During ovulation, one of the ovaries releases an egg, and if fertilized by sperm, a pregnancy occurs. Sometimes, the ovary can produce more than one egg in a month, leading to the possibility of multiple pregnancies.

The ovaries also produce the hormones Estrogen and Progesterone and grow eggs until you reach menopause.

What is Primary Ovarian Insufficiency?

This condition is also known as premature ovarian failure. In this case, the ovaries cease to produce Estrogen, leading to irregular menstrual cycles. Primary ovarian insufficiency may cause the ovaries to stop their essential function of making eggs before reaching menopause.

This condition affects about 1% of women and is more common in women with autoimmune diseases, with the incidence of ovarian insufficiency ranging from 4% to 30% among them.

Causes of Primary Ovarian Insufficiency

Genetic Causes

In about 28% of cases of primary ovarian insufficiency, the cause is genetic. It can result from genetic conditions like Turner and fragile X chromosome syndrome.

Exposure to Toxins

Exposure to toxic substances such as chemotherapy and radiation therapy for cancer, certain pesticides, and smoking.

Autoimmune Disorders

In some autoimmune disorders, the body's immune system attacks the ovaries, causing them to malfunction.

Symptoms 

There is a significant overlap between the symptoms of primary ovarian insufficiency, premenopausal signs, and menopausal symptoms. Here are the main symptoms of this condition:

• Pain during intercourse
• Irregular menstrual cycles
• Decreased libido
• Vaginal dryness
• Difficulty getting pregnant.
• Hot flashes
• Sleep disturbances
• Excessive sweating
• Difficulty concentrating
• Dry eyes

Diagnosis

If you are experiencing a combination of the symptoms mentioned above, consult a gynecologist who will take the following steps:

• The doctor will review your medical history and inquire about the regularity of your menstrual cycle. She may also ask about any medication supplements you are taking or the possibility of exposure to toxic substances.
• Your doctor may request genetic tests.
• A pelvic ultrasound will be performed to examine the uterus.
• The doctor will order laboratory tests to check various hormone levels.
• Sometimes, the doctor may also request a bone density test to ensure you do not have osteoporosis.

Does Primary Ovarian Insufficiency Affect Fertility?

This depends on the severity of the condition and the extent of ovarian insufficiency, whether the menstrual cycle has stopped entirely or is irregular. The severity of the disease, overall health, and test results are the factors that will guide a fertility specialist toward the appropriate plan for addressing delayed fertility, whether it involves artificial insemination, fertility-stimulating medications, in vitro fertilization, or other fertility treatments available.

Treatment for Primary Ovarian Insufficiency

There is currently no cure for this condition, but there are treatment options to mitigate its impact on a woman's health, including:

• Hormone Replacement Therapy
• Fertility treatment if there is a desire for pregnancy.
• Preserving fertility through Egg Freezing.
• Taking calcium and vitamin D supplements to prevent osteoporosis.
• Psychological treatment if this condition leads to depression or anxiety.

Complications

It is essential to monitor this condition with a specialized doctor and seek appropriate medical advice and treatment because primary ovarian insufficiency may lead to various health complications, including:

• Endocrine problems such as Type 2 diabetes.
• Thyroid gland disorders
• Osteoporosis
• Rheumatoid arthritis
• Cardiovascular diseases
• Iron deficiency
• Lupus
• Chronic dry eyes

In conclusion, this condition affects not only your fertility and attempts to conceive but also your overall health. Therefore, it is essential to take care of your physical and mental health and consult healthcare professionals to receive appropriate medical advice for your situation.