Clinical Analysis Of 35 Cases With Premature Ovarian Failure

Backgroud:Premature ovarian failure (POF) is the syndrome that female before the age of 40, normal or delayed puberty menstruation, with normal female secondary sexual characteristics,apprear persistent amenorrhea and genital atrophy, accompanied by follicle stimulating hormone (FSH) and luteinizing hormone (LH) increase, while estrogen reduces.In the primary amenorrhea POF occupies 10% to 28%, in the secondary amenorrhea,4%～18%. It is reported that the incidence rate of POF is 1%～3.8%in China, while 1% in foreign. And in nearly 10 years,the incidence of premature ovarian failure in women of childbearing age have increased year by year and have the trend to younger age. POF is harmful to women's health, leading to a series of reproductive endocrinologic and health problems. POF needs more and more attention when its exact cause is unclear, and is difficult to treat.Objects:The pueposes of this study are to figure out the clinical features and treatment effectiveness of POF and guide diagnosis and treatment of it by analyzing the clinical and teatment data of 35 cases of POF.Methods:To gather clinic data, including age, menarche age, previous menstrual condition, past history, surgical history(family history, reproductive hormone levels, the uterine and ovarian size over B-Ultrasound. body mass index (BMI)of 35 patients who had been to gynaecological clinics of Shandong provincial hospital and people's hospital of Weifang for treatment of POF from January,2008 to November,2009, and 30 cases of normal women of childbearing age Over the same period as control group. Besides asked menopause age, menopause years, hormone replacement therapy situation, and had blood chromosome tests of POF group.And POF patients were divided into younger age groups according to age,younger group(onset before the age of 30, including 30 years old) and elder group (onset after 30 years of age); according to course length, patients were divided into short-duration group (≤3 years duration) and long-duration group (duration> 3 years), we compared the levels of serum reproductive hormone of different groups, in order to observe the influence to reproductive hormone levels of age and duration. At last use the SPSS16.0 software package to carry on the analysis to the obtained data, the measurement material with the T-test, the counting material with the chi-square test.Results:1. Compared with the control group, POF group's serum FSH was significantly higher (P<0.01), BMI was greater (P<0.05), while uterine and ovarian volume was significantly smaller (P<0.01), pelvic surgery was more frequently (P <0.05).2. In 35 cases of POF, comparison of FSH and LH levels:the incidence was no significant difference between age groups (P> 0.05), while the long course of disease was significantly lower than short-course group (P<0.05) 3. after artificial cycle by estrogen and progesterone treatment for 6 months, low estrogen levels had varying degrees of improvement in clinical symptoms,30 cases menstrual cramped during the treatment, while 5 cases were ineffective. The effectiveness reached 86%. But most of the patients after treatment recured amenorrhea, only 5 cases were still menstruating after six months.4,Artificial cycle treatment after 6 months withdrawal a month later, reexamined serum FSH, LH, E2 levels, the results showed that after treatment, serum FSH and LH is lower than before, E2 is higher than before. The differences were statistically significant (P<0.05),POF patients showed normal female karyotype 46xx.Conclusion:1. POF has the clinical features that high gonadotropin and low estrogen, uterine and ovarian narrow, with different degree of hot flashes, sweating, insomnia, irritability or depression, memory loss, infertility, breast atrophy, vaginal dryness, repeated occurrence of symptoms such as vaginitis and urinary tract infection.2. Cause of premature ovarian failure is still unclear, the history of pelvic surgery may be one of its causes.3. POF patients with elevated FSH and LH was negatively correlated with the course, and had nothing to do with age.4.POF is not an entirely irreversible process, the majority of patients after hormone replacement therapy menstrual cramp, but after stopping drug there is high incidence of amenorrhea again, so currently there are no effective and lasting treatments, hormone replacement therapy can improve the clinical symptoms, prevention complications.