No abstract available.
Pregnancy* ; Primary Ovarian Insufficiency*

Primordial follicle activation is a process in which individual primordial follicles leave their dormant state and enter a growth phase. While existing hormone stimulation strategies targeted the growing follicles, the remaining dormant primordial follicles were ruled out from clinical use. Recently, in vitro activation (IVA), which is a method for controlling primordial follicle activation, has provided an innovative technology for primary ovarian insufficiency (POI) patients. IVA was developed based on Hippo signaling and phosphatase and tensin homolog (PTEN)/phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT)/forkhead box O3 (FOXO3) signaling modulation. With this method, dormant primordial follicles are activated to enter growth phase and developed into competent oocytes. IVA has been successfully applied in POI patients who only have a few remaining remnant primordial follicles in the ovary, and healthy pregnancies and deliveries have been reported. IVA may also provide a promising option for fertility preservation in cancer patients and prepubertal girls whose fertility preservation choices are limited to tissue cryopreservation. Here, we review the basic mechanisms, translational studies, and current clinical results for IVA. Limitations and further study requirements that could potentially optimize IVA for future use will also be discussed.
Cryopreservation ; Female ; Fertility Preservation ; Humans ; In Vitro Techniques ; Methods ; Oocytes ; Ovarian Follicle ; Ovary ; Phosphotransferases ; Pregnancy ; Primary Ovarian Insufficiency

This review focuses on the current options for fertility preservation in patients with high risk of premature ovarian failure. Available cryopreservation options include embryo cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation. Ovarian tissue cryopreservation and transplantation has been tried for some time in animals, but only recently successful pregnancy and livebirth in human has been reported. Options of developing follicles and restoring fertility after ovarian tissue cryopreservation are autotransplantation, xenotransplantation, and tissue culture. This review discusses the merits and faults of each option and future directions for developing and standardizing the ovarian tissue cryopreservation and transplantation procedure, systemically covering previously published data.
Animals ; Autografts ; Cryopreservation* ; Embryonic Structures ; Fertility ; Fertility Preservation ; Humans ; Oocytes ; Pregnancy ; Primary Ovarian Insufficiency ; Transplantation, Heterologous

OBJECTIVETo summarize the clinical features of idiopathic premature ovarian failure (POF) and explore the early diagnosis and intervention.

METHODSA retrospective study was conducted in 39 women with idiopathic POF treated between February, 2009 and January, 2010. The clinical data of the patients including the menstrual feature, POF incidence, vaginal ultrasound and pregnancy outcomes were investigated.

RESULTSOne patient had primary amenorrhea and 38 had secondary amenorrhea with an average duration of amenorrhea of 5.82 years. Abrupt cessation occurred after 1-2 menstruations following the menarche in 2 cases (5.1%) and without identifiable preceding signs in 9 cases (23%). The mean uterine and ovarian volume was significantly smaller in POF group than in the control group. Antral follicle count (AFC) was also significantly lower in POF group. Vaginal ultrasound detected at least one ovary in 89.7% and follicular activity in 79.5% of the POF patients. Evidence of ovulation was found in 12 patients, and spontaneous pregnancy occurred in 2 patients with a pregnancy rate of 5.1%.

CONCLUSIONPatients with menstrual disturbance, polymenorrhea and oligomenorrhea are at risk of developing POF, in which case regular detection of the mean uterine volume, ovarian volume and AFC by vaginal ultrasound may help in early POF detection. Close monitoring can be necessary in the course of hormone replacement therapy, and timely intervention with assisted reproductive techniques may increase the chance of pregnancy.

Primary ovarian ectopic pregnancy, is one of the rarest forms of ectopic pregnancy. Ovarian ectopic pregnancy may occur with or without the essence of any of the classical risk factors or signs and symptoms. The diagnosis is made often at surgery and required histologic confirmation. This is a case of a primary ovarian pregnancy in a 36-year old elderly primigravida who presented with abdominal pain and subsequently underwent ovarian wedge resection. Diagnosis of ovarian pregnancy was later confirmed using the Spiegelberg criteria. This paper presents a review of literature regarding ovarian pregnancy's clinical presentation, risk factors, and the possibility of a conservative management.

OBJECTIVE: To observe the influence of regulating menstruation and promoting pregnancy acupuncture therapy on negative emotions in patients with premature ovarian insufficiency (POI). METHODS: A total of 60 patients with POI were randomly divided into an acupuncture group and a western medication group, 30 cases in each group. The acupuncture group was treated with regulating menstruation and promoting pregnancy acupuncture therapy at Baihui (GV 20), Shenting (GV 24), Guanyuan (CV 4), Sanyinjiao (SP 6), Shenshu (BL 23), Ciliao (BL 32), etc. once a day, 5 times a week for 3 months. The western medication group was treated by oral administration of climen. The drug was given 1 tablet a day for 21 days and was stopped for 1 week as a course. The treatment was required 3 consecutive courses. The self-rating anxiety scale (SAS) score, modified Kupperman index (KI) score, agitated and depressive symptom scores in KI and serum level of follicle stimulating hormone (FSH) before and after treatment were compared between the two groups. RESULTS: After treatment, the SAS scores, KI scores and serum levels of FSH in the two groups and the scores of agitated and depressive symptom in the acupuncture group were lower than those before treatment ( CONCLUSION Regulating menstruation and promoting pregnancy acupuncture therapy can effectively improve the negative emotions of patients with POI and reduce serum level of FSH .
Acupuncture Points ; Acupuncture Therapy ; Female ; Follicle Stimulating Hormone ; Humans ; Menstruation ; Pregnancy ; Primary Ovarian Insufficiency/therapy*

Premature ovarian failure (POF) is a syndrome defined as hypergonadotropic hypogonadism associated with amenorrhea, oligomenorrhea or other forms of menstrual irregularity for at least 3 consecutive months before the age of 40. The management of POF is approached by HRT, emotional support and infertility treatment. Women with premature ovarian failure who desire to become pregnant are best treated by assisted reproductive technology with donor oocyte. However, POF has the possibility of a 5-10% spontaneous pregnancy. The physician should recommend the patient to consult with their physician if they have any symptoms of pregnancy or no withdrawal bleeding after HRT. Therefore we report two cases of spontaneous pregnancies in women with premature ovarian failure.
Amenorrhea ; Female ; Hemorrhage ; Humans ; Hypogonadism ; Infertility ; Oligomenorrhea ; Oocytes ; Pregnancy* ; Primary Ovarian Insufficiency* ; Reproductive Techniques, Assisted ; Tissue Donors

Hepatoid carcinoma is a rare type of malignant tumor resembling hepatocellular carcinoma that arises in extrahepatic sites.(stomach, lung, ovary, pancreas, bladder and renal pelvis). Hepatoid carcinoma of the ovary is an extremely rare ovarian tumor, first described by Ishikura and Scully in 1987. Histologically it is important to differentiate this entity from other oxyphil tumors of the ovary as it requires aggressive treatment. We have experienced a case of hepatoid carcinoma of the ovary in 69-year-old postmenopausal woman, who has been treated with operation and adjuvant Taxol - cisplatin chemotherapy. We present this case with brief review of literatures.
Aged ; Carcinoma, Hepatocellular ; Cisplatin ; Drug Therapy ; Female ; Humans ; Lung ; Ovary ; Paclitaxel ; Pancreas ; Pregnancy* ; Primary Ovarian Insufficiency* ; Urinary Bladder

Turner syndrome with abnormalities of X chromosome is generally characterized by gonadal dysgenesis causing premature ovarian failure, primary and secondary amenorrhea. Premature ovarian failure is often caused by X chromosome aberrations. It has been shown that gross X chromosome abnormalities such as monosomy X usually result in primary amenorrhea and poor pubertal development, whereas mild X chromosome abnormalities such as partial X deletions usually lead to secondary amenorrhea and fairly good pubertal development. Fertility has been reported in several patients with relatively small Xq deletions before the onset of premature ovarian failure, and the X chromosome abnormality is often inherited by offspring. We describe a 46,X,del(X)(q26) female with normal pregnancy, in whom same karyotype was found in the fetus by amniocentesis. We report this case with brief review of related literatures.
Amenorrhea ; Amniocentesis ; Female ; Fertility ; Fetus* ; Gonadal Dysgenesis ; Humans ; Karyotype* ; Pregnancy ; Pregnant Women* ; Primary Ovarian Insufficiency ; Turner Syndrome ; X Chromosome

OBJECTIVE: To assess the effects of a gonadotropin-releasing hormone agonist (GnRH-a) depot (Leuprolide acetate) in women with gynecologic cancer receiving chemotherapy while taking a continuous add-back on the prevention of premature ovarian failure. METHODS: Fourteen premenopausal patients with gynecological malignancies who had undergone conservation of ovaries surgery received a GnRH-a depot plus add-back until chemotherapy was completed. Four weeks thereafter, a hormonal profile (follicle stimulating hormone) was measured. RESULTS: The mean follicle stimulating hormone level was 15.8 IU/L. All patients exhibited a restoration of ovarian failure during follow-up. One patient became pregnant during the follow-up period. CONCLUSION: In the short term, GnRH-a appears to protect ovarian function and ability to achieve pregnancy following chemotherapy. The result of our study needs further elucidation in a large randomized controlled trial.
Chemotherapy, Adjuvant ; Drug Therapy* ; Female ; Fertility Preservation ; Follicle Stimulating Hormone ; Follow-Up Studies ; Gonadotropin-Releasing Hormone* ; Humans ; Ovarian Neoplasms ; Ovary ; Pregnancy ; Primary Ovarian Insufficiency ; Uterine Cervical Neoplasms