Long-term health of women with genetic POI due to FSH-resistant ovaries

Abstract

Objective: To study the use of hormone therapy (HT), morbidity and reproductive outcomes of women with primary ovarian insufficiency (POI) due to FSH-resistant ovaries (FSHRO). Design: A prospective follow-up study in a university-based tertiary c linic setting. Methods: Twenty-six women with an inactivating A189V FSH receptor mutat ion were investigated by means of a health questionnaire and clinical ex amination. Twenty-two returned the health questionnaire and 14 were clinically examin ed. Main outcome measures in the health questionnaire were reported as HT, morbidity, medication and infertility treatment outcomes. In the clinical study, risk factors for cardiovascular disease (CVD) and metabolic syndrome (MetS) were compared to ag e-matched controls from a national population survey (FINRISK). Average number of controls was 326 per FSHRO subject (range 178–430). Bone mineral density and whole-b ody composition were analyzed with DXA. Psychological and sexual well-being was assessed with Beck Depression Inventory (BDI21), Generalized Anxiety Disorder 7 (G AD-7) and Female Sexual Function Index (FSFI) questionnaires. Results: HT was initiated late (median 18 years of age) compared with n ormal puberty and the median time of use was shorter (20–22 years) than the n ormal fertile period. Osteopenia was detected in 9/14 of the FSHRO women despite HT. No major risk factors for CVD or diabetes were found. Conclusions: HT of 20 years seems to be associated with a similar cardiovascular and metabolic risk factor profile as in the population control group . However, optimal bone health may require an early-onset and longer period of HT, whic h would better correspond to the natural fertile period.

Keywords

• POI
• primary ovarian insufficiency
• primary amenorrhea
• FSH receptor
• osteopenia