Long‐term outcome of ovarian function in women with intermittent premature ovarian insufficiency
2017
Context
Spontaneous resumption of ovarian function is not a rare phenomenon in patients with premature ovarian insufficiency (POI). The outcome of this resumption is not known.
Objective
To describe the outcome following the resumption of ovarian function in POI patients.
Design
Cross sectional study.
Setting
University medical centre.
Patients and main outcome measures
Cumulative incidence of ovarian function resumption and risk factors arresting this resumption during follow-up were determined in a large cohort of POI women.
Results
Five hundred and seven patients were included in the study, with a follow up of 3.44±4.05 years [0-29]. Of these, 117 (23%) had features of ovarian function resumption. The cumulative incidence of pregnancy was 3.5% among the whole cohort and 15.3% among patients with resumption of ovarian function. Fifty-five patients (47%) experienced an arrest of their resumption during the follow up period. In univariate analysis, high FSH and DHEA levels at initial evaluation were risk factors for the arrest of the resumption of ovarian function. In multivariate analysis, high FSH levels at the initial evaluation (1.89 [1.10-3.23], p=0.03) and older age at diagnosis (1.53 [1.01-2.33], p=0.04) were risk factors for the arrest of this resumption.
Conclusion
Resumption of ovarian function is not a rare or brief phenomenon in POI women. The identification of predictive factors of this resumption, as well as its duration, increases our knowledge of the natural history of POI, and will improve the medical management, especially infertility counselling of these patients.
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