International Journal of Reproductive BioMedicine
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences of Yazd
Vol. 13, No. 8, 2015, pp. 461-472
Bioline Code: rm15062
Full paper language: English
Document type: Review Article
Document available free of charge
International Journal of Reproductive BioMedicine, Vol. 13, No. 8, 2015, pp. 461-472
© Copyright 2015 - Iranian Journal of Reproductive Medicine
The role of autoimmunity in premature ovarian failure|
Ebrahimi, Mahbod & Asbagh, Firouzeh Akbari
Premature ovarian failure (POF) is a heterogeneous syndrome with several causative
factors. Autoimmune mechanisms are involved in pathogenesis of 4-30 % of POF
cases. The present review focuses on the role of autoimmunity in the
pathophysiology of POF. The evidences for an autoimmune etiology are:
demonstration of ovarian autoantibodies, the presence of lymphocytic oophoritis,
and association with other autoimmune disorders. Several ovarian antigenic targets
have been identified in POF patients. The oocyte seems to be the most often targeted
cell. Lymphocytic oophoritis is widely present in POF associated adrenal
insufficiency. Addisonsۥ disease is one of the most common autoimmune disorders
associated with POF. Early detection of this potentially life threatening disease was
recommended in several studies.
The gold standard for detecting autoimmune POF is ovarian biopsy. This procedure is not recommended due to unknown clinical value, expense, and risks. Several immunoassays have been proposed as substitute diagnostic tools. Nevertheless, there is no clinically proven sensitive and specific serum test to confirm the diagnosis of autoimmune POF or to anticipate the patient’s chance of developing POF or associated diseases.
Some authors suggested the possible effects of immuno-modulating therapy on the resumption of ovarian function and fertility in a selected group of autoimmune POF patients. However, in most instances, this treatment fails to reverse the course of the disease.
Numerous studies illustrated that standard treatment outcome for infertility is less effective in the presence of ovarian autoimmunity. The antibody-induced damage could be a pathogenic factor. Nevertheless, the precise cause remains obscure.
Premature ovarian failure; Premature ovarian insufficiency; Autoimmune oophoritis; Autoimmunity
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