Diagnosis Of Ovarian Insufficiency Research Articles

Экспрессия miR-181a и miR-146a при преждевременной овариальной недостаточности аутоиммунной этиологии

Objective. To study the expression of miR-181a and miR-146a in the blood serum obtained from an experimental animal model of autoimmune oophoritis on different days of the experiment to assess their role in primary ovarian insufficiency (POI) of autoimmune etiology. Materials and methods. Experimental animals were mature female outbred rats. The study group (n = 25) included the experimental animal model of autoimmune oophoritis, the control group (n = 20) – intact animals. Morphometry of ovarian samples with estimating the average number of follicles, corpora lutea and atretic corpora lutea was performed. Enzyme immunoassay was used to study the concentration levels of serum anti-Mullerian Hormone (AMH) and anti-ovarian antibodies (AOA). MicroRNAs were isolated from serum according to a standard protocol; a reverse transcription and real-time polymerase chain reaction were performed using specific primers, and the relative expression of miR-181a and miR-146a was calculated by the Pfaffle method. Results. The expression of miR-146a on different days of the experiment remained statistically insignificant, including when compared to the control group. The expression of miR-181a in the blood serum of experimental animals on day 15 was statistically significantly higher than similar values on days 5, 10, 30 and 60 and in the control group. Conclusion. MiR-181a showed high diagnostic value in POI of autoimmune etiology in the experiment performed and can serve as an early marker in the diagnosis of ovarian insufficiency. The role of miR-146a as a marker of POI of autoimmune etiology has not been experimentally confirmed. Key words: autoimmune oophoritis, microRNA, experiment, premature ovarian insufficiency

Emotional Impacts of Premature Ovarian Failure in Kuwait

Premature Ovarian Failure (POF) is cessation of ovarian functions before the age of 40 years with consequent cessation of menstruation. The objective of study was therefore to evaluate the emotional reaction and self-efficacy of women with POF. Forty-two women confirmed to have Premature Ovarian Failure seen at the outpatient clinic of Maternity Hospital fulfilled the study criteria, were enrolled into the study. Another group of 42 healthy women formed the control group. The instrument of data collection included three types of questionnaires to assess the depth of emotional reaction to the diagnosis of POF including the subjects’ biodata, modified Health Orientation Scale (HOS) and Stanford Chronic Disease Self-Efficacy Scale. The women with POF presented at the clinic with infertility (P P P < 0.05). The diagnosis of ovarian insufficiency was a traumatic life event similar to bereavement (grieving of no obvious loss to others), with high level of anxiety, depression, fear of divorce, lower life satisfaction and impaired self-esteem. Fertility was generally of profound concern to all of them, because fertility was a societal landmark of womanhood and youth. The Stanford Chronic Self Efficacy scores were generally low (below 7) in coping with emotion reaction to loss of fertility, loss of menstruation, loss of self-esteem and other significant emotional reactions. The present study has demonstrated that Premature Ovarian Failure is associated with severe emotional distress and impaired ability to cope with them especially low self-esteem. A multidisciplinary management team is advocated for POF.

Primary Ovarian Insufficiency due to Steroidogenic Cell Autoimmunity Is Associated with a Preserved Pool of Functioning Follicles

Primary ovarian insufficiency (POI) is defined as hypergonadotropic amenorrhea before the age of 40 yr. In 4-5% of patients with POI, an ovarian autoimmune process is present. Serum concentrations of antimüllerian hormone (AMH) have been determined in 26 women with POI due to steroidogenic cell autoimmunity (SCA-POI), 66 with nonautoimmune idiopathic POI (iPOI), 40 postmenopausal women (PMW), and 44 healthy fertile women (HW). SCA-POI was diagnosed according to presence of steroidogenic enzyme autoantibodies (17alpha-hydroxylase, side chain cleavage, and 21-hydroxylase autoantibodies). AMH concentrations were significantly higher in women with SCA-POI than women with iPOI (P = 0.018) or PMW (P = 0.03) but significantly lower than HW (P < 0.0001). AMH was detected in 11 of 26 women with SCA-POI (42%) and seven of 66 with iPOI (11%) (P = 0.002). Serum concentrations above the fifth percentile of the normal range (0.6 ng/ml) were detected in nine of 26 women with SCA-POI (35%) and four of 66 with iPOI (6%) (P = 0.001). Eight of 12 women with SCA-POI with less than 5 yr (67%) and one of 14 with longer disease duration (7%) had AMH concentrations within the normal range (P = 0.003). AMH concentrations correlated inversely with disease duration in women with SCA-POI (rho = -0.563, P = 0.003) but not women with iPOI. AMH correlated inversely with FSH serum concentrations in HW (rho = -0.584, P < 0.001) but not PMW or women with POI. Two thirds of women with recent-onset SCA-POI had normal AMH concentrations. Women with SCA-POI, differently from those with iPOI, present a preserved ovarian follicle pool for several years after diagnosis of ovarian insufficiency.