POF What option we have

Point 1: Prevalence of POF?? Spontaneous onset POF affects 1% of women under 40 years, 0.1% of patients younger than 30 years, and 0.01% of patients under the age of 20 years.  Nowadays, with the increase in success rates of cancer treatment in children and in young women, the incidence of POF is rapidly rising.

 Point 2: Decline in no of growing follicles : Every woman behaves differently : In many situations, women of the same age are different with response to ovarian stimulation and some of young women under age 35 have a DOR and poor IVF outcome. A useful predictor of ovarian response to ovulation induction is thus needed. 



Point 3: Age of the female is the one of the most important factors in determining the quality and quantity of oocytes produced in a stimulated cycle, also an important predictor of pregnancy outcome. As a woman grows older, her ovarian reserve and her ability to conceive decrease both in natural cycle and assisted reproductive techniques cycle. 
Point 4 : Cause of POF?? Primary POF is idiopathic in about 90% of cases.
Possible reasons behind POF can be principally divided into A) chromosomal and B) nonchromosomal anomalies. About 50% of women with POF with primary amenorrhoea have associated chromosomal abnormalities,  whereas associated chromosomal abnormalities are much less common in women with secondary amenorrhoea. Autoimmune diseases, infective causes such as herpes virus, cytomegalovirus, mumps, and idiopathic. It is estimated that the 2-8% of women with mumps oophoritis develop a commonly transitory ovarian failure. Cigarette smoking was observed to be associated with an augmented risk of idiopathic POF, whereas oral contraceptive use was found to reduce the risk of early menopause in a study.



Point 5 : How   autoimmune disorders     affect  the process of  POF ? Ans: The relationship between POF and autoimmune disorders is well documented. POF is an associated occurrence in about 25% of cases of hypothyroidism, in 3% of Addison's disease, and in 2.5% of diabetes mellitus.  POF it is also associated with autoimmune polyendocrine syndromes types 1 and 2, pernicious anemia, systemic lupus erythematosus, rheumatoid arthritis, and vitiligo. Around 50% of patients with POF have ovarian antibodies, but their clinical relevance is not well defined due to their high prevalence (31%) in women with normal ovarian reserve