Detection Of Autoimmunity In Women With 46, XX Spontaneous Premature Ovarian Failure

Background and Objective:Premature ovarian failure (POF) is defined as oligomenorrhea or amenorrhea for at least 4 months, with high hypergonadotropic hypogonadism. Symptoms of estrogen deficiency develop in most, but not all, patients, including vasomotor symptoms (hot flashes and night sweats), depression, low libido. It affects approximately 1% of women under 40 years,0.1% under 30 years. Most of the causes and mechanisms of POF remain a mystery. The aetiology includes genetic factor (numeral or structural abnormalities, specific gene mutations), autoimmune imbalance, iatrogenic factor (surgery, radiochemotherapy), poison exposure, but the pathophysiologic and clinical features could not be comprehensively uncovered by these causes. And most cases are definitively defined as idiopathic premature ovarian failure. Recent research find that the ovarian dysfunction is not irreversible, and some women receiving the diagnosis have intermittent ovarian function leading to unpredictable menses and pregnancy. Autoimmune oophoritis is one of the reversible etiolgies, to test the autoimmune condition of idiopathic premature ovarian failure may lead to evidences of immune causes. And the immunosuppressive therapy may improve the ovarian reserve and fertility. The objective of the present study is to detect the autoimmune condition in women with 46,XX spontaneous POF for clinical diagnosis and management.Material and methods:Forty-eight women with 46,XX POF were selected as study group, and forty infertile women free of hyperandrogenism, polycystic ovaries(PCO), autoimmune diseases and recurrent spontaneous abortion(RSA) with regular menstrual cycle and normal TSH were enrolled as control group. The serum level of antinuclear antibody (ANA), anti-double-stranded DNA (ds-DNA), anticardiolipin antibody (ACA), antithyroid peroxidase antibody (TPO-Ab), antithyroglobulin antibody (TG-Ab), anti-adrenal cortex antibody (AAA) were detected and compared between the two groups. Chi-square test was used for data analysis.Result:The positive rates of serum ANA, ds-DNA, ACA,TPO-Ab, TG-Ab in the study group are 2.01%,2.01%,2.01%,14.58%,14.58%, and 0%,0%,0%,10%,12.5% in the control group, respectively. There is no statistical difference in the positive rates of serum ANA, ds-DNA, ACA,TPO-Ab, TG-Ab between two groups (P＞0.05). The positive rate of serum AAA in the study group was significantly higher than that in the control group (18.75% vs 2.7%, P＜0.05).Conclusion:Autoimmune antibodies can be detected in some women with 46, XX POF, indicating that POF is associated with autoimmune imbalance. AAA is effective to diagnose autoimmune premature ovarian failure. Future studies in large cohort are warranted to establish definite association between AAA and POF.