Fertility and Ovarian Failure Syndrome In Conventional Medicine Perspective

I. Definition 
Premature ovarian failure is also known as primary ovarian insufficiency. It is defined as a condition of women before age of 40 of which the brain does not response to high levels of FSH in making egg, due to an insufficiency of estrogen. 

II. Diagnosis 
If you have some of the symptoms below, your doctor may order a blood test for hormones and the levels of FSH hormone, if your blood test indicated a high levels of FSH (follicle Stimulating Hormone), you may suspect to have premature ovarian failure. It's usually necessary to repeat the blood test to make sure the first test was correct. Sometimes, a chomid challenging test is require to confirm the first test result. 

III. Causes 
The causes of POFs is known, but some researchers suspect 
1. Autoimmune disorders 
It is caused by abnormal function of immune system in producing antibody antigen that destroys the body tissues, leading to the destruction of ovarian function. 

2. Turner syndrome 
It is genetic cause of POF as resulting of a complete or near-complete loss of the second X, because it requires to have 2 functioning X chromosomes for normal ovarian function. 

3. Fragile X syndrome 
It is the most common cause of inherited mental impairment and associated with premutation form of the FMR1 gene, leading to increasing the risk of premature ovarian failure or early menopause.The premutation form of the FMR1 gene can be easily detected in blood or cheek cells via a DNA test. 

4. Chemotherapy and radiation 
It is said that chemotherapy and radiation to the pelvic region may damage the uterus, leading to abnormal function of the ovaries resulting in infertility and early menopause. 

6. Surgery 
Any sugery involve removal of the uterus without removing the ovaries may increase the risk of premature ovarian failure. 

7. Enzymes deficiency 
It is asid that women can not produce enough certain enzymes such as enzyme 17 alpha hydroxylase and 17 and 20 lesmolase may increase the risk of POF as resulting of low levels of estrogen being produced. 

8. Infection 
Infections such as chickenpox, malaria, tuberculosis and mumps may increase the risk of premature ovarian failure. 


IV. Symptoms 
Symptoms of POFs is similar to symptoms of menopause, include 
1. Irregular periods (different length of bleeding or change in flow) 
2. Hot flashes caused by low levels of estrogen. 
3. Night sweats caused by low levels pf estrogen 
4. Decrease in sexual drive caused by low levels of testosterone 
5. Irritability caused by low levels of estrogen 
6. Painful sex caused by thinning and drying of vagina 


V. Treatments 
1. Estrogen therapy 
a) How it works 
Estrogen therapy (ET) is a medical treatment with a medication containing only estrogen hormone. Estrogen-only therapy helps to increase the estrogen levels, thereby, stimulating the communication of the brain as the increaseing of FSH hormone to induce egg production and egg extruding. It is said that Estrogen therapy has helped many women with POF to conceive. 

b) Risks 
i) Heart diseases 
ii) Blood clotting 
iii) Breast cancer 
iv) Gallbladder diseases 

c) Side effects 
Some women may experience the below side effects 
i) Fluid retention, 
ii) Bloating, 
iii) Nausea, 
iv) Breast tenderness 
v) Mood swings 
vi) Headache 


2. Estradiol 
a) How is works 
Estradiol is actually a type of estrogen, by injecting the synthesis form of estradiol , it stimulates the brain to shut off the production of FSH leading to egg maturing and extruding into Fallopian tube for natural fertilzation. 
b) Risks 
i) Endometrial hyperplasia 
ii) Cancer of the lining of the uterus 
iii) Stroke 
iv) Breast cancer 

c) Side effects 
i)Uterine bleeding, 
ii) Breast tenderness, 
iii) Nausea and vomiting, 
iv) Chloasma, 
v) Cholestasis, 
vi) Migraine headaches 

3. Hormone replacement therapy HRT 
a) How HRT works 
Hormone replacement therapy provide estrogen and other hormone which are necessary the natural process of menstrual cycle, by signalling the production of LH and FSH as well as signalling the release of mature egg to the Fallopian tube. 

b) Risks 
i) Liver disease 
ii) Breast cancer 
iii) Uterus cancer 
iv) Blood clots in the vein, legs, or lungs 
v) Gallbladder disease 
vi) Heart diseases or stroke 

c) Side effects 
i) Vaginal bleeding of unknown cause 
ii) Breast pain 
iii) Nausea 
iv) Bloating and fluid retention 
v) Blood clots in the vein, legs, or lungs. 
vi) Moodswing 

4. Clomid (Clomiphene citrate) 
a) How it works 
Clomid stimulates the pituitary gland in secreting, leading to maturing of some eggs and ovulation. 

b) Risks 
i) Ovarian hyperstimulation 
ii) Multiple birth 
iii) Cancer 

c) Side effects 
i ) Hot Flashes 
ii) Bloating 
iii) Abdominal paid and cramps 
iv) Weight gain 
v) Moodswing 
vi) Nausea and dizziness 
vii) Abnormal menstrual bleeding 
viii) Visual disturbances 

6. Cytoplasm 
This is a new kind of treatment, by taking DNA from your healthy egg and places it inside the nutrient components of a donor's egg as your DNA goes into the healthy egg for artificial insemination. 


7. Artificial Insemination 
Some doctors also try to use IVF with donor egg, while it gives the woman a baby but it dose not address the underline failure of the ovaries and other symptoms of menopause. 
Unfortunately, the success rate for a happy conception for women with premature ovarian failure is about 5%.