FAQ

It is a common gynecological endocrine disease leading to infertility. It is characterized by the loss of ovarian function below 40 years, and it is the cause of 10-28% of cases of primary amenorrhoea (menses lack by the age of 16 years) and of 4-18% of cases of secondary amenorrhoea (menses interruption lasting at least 6 months).

Most often, it is a non-reversible pathology.

POF prevalence is 1/250 in women under 35 years and 1/100 in women under 40 years.

Its incidence increases with advancing age, being recognized in:

• 0.01% of women younger than 20 years;
• 0.1% of women younger than 30 years;
• 1% of women younger than 40 years.

In more than 90% of cases no cause is defined. However, it is known that it can be a spontaneous event, or it can depend on:

• genetic, endocrine, paracrine, mitochondrial dysfunction-related, and metabolic factors affecting follicles and oocytes quality;
• chemotherapy, radiotherapy, and surgery;
• autoimmune reactions;
• viral or bacterial infections.

A prompt diagnosis is fundamental to avoid severe symptoms and long-term hormone deficiency consequences.

Symptoms requiring medical evaluation include new-onset menstrual irregularities (presenting either as infrequent menses or too frequent menstruation) and fertility issues.

Clinical treatment of choice is estrogen supplementation; progesterone can help minimize endometrial hyperplasia or cancer risk, and in selected cases testosterone can help address decreased libido.

POF treatment can involve infertility therapy too. Moreover, fertility preservation after anticancer therapy can be achieved through:

• suppression of ovarian function prior to chemotherapy;
• re-transplantation of an in vitro activated ovary;
• cryopreservation of ovarian tissue, mature oocytes or embryos.

Mesenchymal stem cells transplantation aims at restore ovarian function. It improves hormone production, ovarian structure, endometrial thickness, and blood flow in the endometrium. It is an effective, tolerable, safe, and minimally immunogenic therapy. The use of autologous stem cells mitigate any immunogenic concern.

Adipose-derived mesenchymal stem cells are easy to isolate and expand. All is required are 20 cc of fat collected during a quick and painless outpatient procedure. Cells not immediately utilized can be cryopreserved for future treatment.