Abstract
Background: Primary ovarian insufficiency (POI) is a devastating diagnosis for reproductive-aged women due to the associated infertility and other serious health consequences. Spontaneous pregnancy without hormone replacement therapy (HRT) and/or assisted reproductive technology (ART) rarely occurs in POI patients, particularly in those patients with long-term amenorrhea.Case: On March 4, 2019, a 31-year-old Chinese POI patient visited our hospital for a spontaneous pregnancy after 10 years of amenorrhea and discontinuation of HRT 4 years prior. The patient had menarche at the age of 13, with 3 years of regular menstruation followed by amenorrhea occurring at the age of 20. POI was diagnosed by several hospitals; chromosome examination revealed a normal 46, XX karyotype. Treatment with estradiol valerate and progesterone did lead to resumed menstruation, while amenorrhea resumed after withdrawal of HRT. The patient married at the age of 23 and tried to conceive by HRT until the age of 25; her beta-human chorionic gonadotropin (HCG), estrogen (E2), and progesterone levels were 32987.7~119151.4 mIU/ml, 671.0~>1,000 pg/mL, and 6.6~27.9 ng/ml, respectively. On March 22, 2019, ultrasonography showed an intrauterine pregnancy with a normally developed gestational sac sized 45 × 42 × 32 mm with a 17 mm crown-rump length. On October 29, a 3,400 g healthy girl baby was delivered; the patient had a spontaneous delivery with natural labor.Conclusion: Spontaneous pregnancy is possible in women with POI and 10 years of amenorrhea.
Highlights
Primary ovarian insufficiency (POI) is a devastating diagnosis for reproductive-aged women due to the associated infertility and other serious health consequences
Reports have shown that ∼5–10% of women conceive and deliver a child after they have received the diagnosis of POI [1,2,3], this term describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins [1,2,3,4]
POI was diagnosed by several hospitals; chromosomal analysis demonstrated a normal female karyotype (46, XX); treatment with estradiol valerate and progesterone led to menstruation, while amenorrhea continued after withdrawal of hormone replacement therapy (HRT)
Summary
Primary ovarian insufficiency (POI) is a devastating diagnosis for reproductive-aged women due to the associated infertility and other serious health consequences. Spontaneous pregnancy without hormone replacement therapy (HRT) and/or assisted reproductive technology (ART) rarely occurs in POI patients, in those patients with long-term amenorrhea. Case: On March 4, 2019, a 31-year-old Chinese POI patient visited our hospital for a spontaneous pregnancy after 10 years of amenorrhea and discontinuation of HRT 4 years prior. The patient had menarche at the age of 13, with 3 years of regular menstruation followed by amenorrhea occurring at the age of 20. Treatment with estradiol valerate and progesterone did lead to resumed menstruation, while amenorrhea resumed after withdrawal of HRT. The patient married at the age of 23 and tried to conceive by HRT until the age of 25; her beta-human chorionic gonadotropin (HCG), estrogen (E2), and progesterone levels were 32987.7∼119151.4 mIU/ml, 671.0∼>1,000 pg/mL, and 6.6∼27.9 ng/ml, respectively. On October 29, a 3,400 g healthy girl baby was delivered; the patient had a spontaneous delivery with natural labor
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
