Estrogen therapy for iatrogenic premature ovarian insufficiency-induced infertility: a case series

KURITANI Yoshihiro, KUBOTA Satoshi, SAWADA Masaaki, TAKAO Tetsuya, MORISHIGE Kenichiro, TAKEMURA Masahiko

doi:10.11437/sanpunosinpo.76.32

Premature ovarian insufficiency (POI) is diagnosed based on amenorrhea (≥4 months) and elevated follicle-stimulating hormone levels (FSH; >25 IU/L). Ovarian dysfunction, characterized by low estradiol and high gonadotropin levels, may cause health problems, including a low spontaneous pregnancy rate and treatment-refractory infertility. Estrogen therapy suppresses serum FSH levels and sensitizes the remaining follicles to exogenous stimulation. Herein, we present the results from a data analysis undertaken to evaluate the rate of follicle development and pregnancy from 36 cycles in three patients with iatrogenic infertility (associated with ovarian surgeries, n=2, and chemotherapy, n=1). Follicle development occurred in two patients (on each with ovarian surgery and post-chemotherapy) within seven cycles, which led to timed intercourse (one cycle), intrauterine insemination (five cycles), and oocyte retrieval (one cycle). The overall rate of follicle development and pregnancy was 19.4% (in 36 cycles) and 0%, respectively. Earlier initiation of estrogen therapy tended to increase the rate of follicle development. Assisted reproductive technology could be recommended for the patients with POI. 〔Adv Obstet Gynecol, 76(1):32-37, 2024(R6.2)〕

Estrogen therapy for iatrogenic premature ovarian insufficiency-induced infertility: a case series

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