Mechanisms of follicular dysfunction in 46,XX spontaneous premature ovarian failure.

Approximately one half of young women who have 46,XX spontaneous premature ovarian failure have ovarian follicles remaining in the ovary. These follicles function intermittently and unpredictably, and pregnancies can occur in these women without intervention, even many years after the diagnosis. Clearly, the term "premature menopause" is an inaccurate term for this condition. At present, there are no proven therapies that will improve follicular function for these women. Inappropriate luteinization related to low follicle number seems to be a major mechanism of follicular dysfunction. Autoimmune oophoritis, although apparently an uncommon cause of follicular dysfunction in these women, nonetheless presents the opportunity to develop an effective therapy to restore fertility. Young women with 46,XX spontaneous premature ovarian failure benefit from the care of a sensitive clinician, one who is willing to spend a little more time informing them about the diagnosis and referring them to other sources of information. With appropriate medical management and emotional support provided by a sensitive clinician, most young women with 46,XX spontaneous premature ovarian failure will lead happy, healthy, and fulfilling lives.