Zhang WY, Wang HB, Deng CY. Intermittent spontaneous ovulation in patients with premature ovarian failure: Three case reports and review of literature. World J Clin Cases 2023; 11(31): 7647-7655 [PMID: 38078130 DOI: 10.12998/wjcc.v11.i31.7647]
Corresponding Author of This Article
Cheng-Yan Deng, MD, Doctor, Professor, Teacher, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. chydmd@hotmail.com
Research Domain of This Article
Reproductive Biology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 6, 2023; 11(31): 7647-7655 Published online Nov 6, 2023. doi: 10.12998/wjcc.v11.i31.7647
Intermittent spontaneous ovulation in patients with premature ovarian failure: Three case reports and review of literature
Wan-Yu Zhang, Han-Bi Wang, Cheng-Yan Deng
Wan-Yu Zhang, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
Han-Bi Wang, Cheng-Yan Deng, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100730, China
Author contributions: Zhang WY reviewed literature and drafted the manuscript; Wang HB obtained patient consent; Deng CY revised the manuscript.
Supported byNational High Level Hospital Clinical Research Funding, No. 2022-PUMCH-B-080; and No. PUMCH-C-064.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cheng-Yan Deng, MD, Doctor, Professor, Teacher, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China. chydmd@hotmail.com
Received: August 11, 2023 Peer-review started: August 11, 2023 First decision: September 26, 2023 Revised: October 15, 2023 Accepted: October 25, 2023 Article in press: October 25, 2023 Published online: November 6, 2023 Processing time: 87 Days and 3.4 Hours
Abstract
BACKGROUND
Premature ovarian failure (POF) is the end-stage of a decline in ovarian function prior to the age of 40 years that involves symptoms associated with low estradiol (E2) levels and a minimal probability of pregnancy. This increases the physical and psychological burden experienced by young women of reproductive age, particularly with regards to over-diagnosis.
CASE SUMMARY
Here, we report three cases (29, 22, and 33 years-of-age) diagnosed with POF after experiencing secondary amenorrhea for more than one year, serum levels of follicle-stimulating hormone (FSH) > 40 IU/L on two occasions with an interval of more than 4 wk, and negative progesterone withdrawal tests. All three patients were intermittently administered with drugs to create an artificial cycle. During the subsequent discontinuation period, the patients experienced intermittent follicular growth and spontaneous ovulation. One patient experienced two natural pregnancies (both with embryo arrest).
CONCLUSION
Our findings suggest that young patients with POF can experience unpredictable and intermittent spontaneous follicular development, ovulation, and even natural pregnancy. Clinicians should provide appropriate medical guidance and individualized treatments according to fertility requirements, genetic risks and hypoestrogenic symptoms as soon as possible.
Core Tip: Three cases (29, 22, and 33 years of age) diagnosed with premature ovarian failure after experiencing secondary amenorrhea for more than one year, serum follicle-stimulating hormone levels > 40 IU/L. During the discontinuation period of artificial cycle, three patients experienced unpredictable and intermittent spontaneous follicle development, ovulation, and even natural pregnancy.
