Spontaneous pregnancy in association with hypergonadotropic ovarian failure

A. G. Shapiro, A. Rubin

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Abstract

As shown by Goldenberg et al., an elevated blood FSH value of 50 mIU/ml or more is diagnostic of the absence of ovarian follicles in women who have primary or secondary amenorrhea. The exception to this is the syndrome of 'hyposensitive' ovaries, where elevated FSH levels are found in association with primordial ovarian follicles. Laparoscopic ovarian biopsy may be unreliable since the follicles may lie deep in the ovarian parenchyma. A somewhat similar situation may exist with menopausal women, in whom intact ovarian follicles and even histologic evidence of a corpus luteum may be found. It would therefore seem reasonable to theorize that the 'hyposensitive' ovary resembles the 'menopausal' ovary, i.e., both having follicles which are unresponsive to relatively high gonadotropin levels. In addition, pregnancies have occurred in menopausal women, suggesting that women with hyposensitive ovarian follicles may, on rare occasions, ovulate and conceive. Of interest, a similar case has recently been reported by Polansky and de Papp concerning a 30-year-old woman with hot flashes, secondary amenorrhea, and elevated gonadotropin levels. Laparoscopically directed ovarian biopsy in their patient revealed a 'total absence of ova.' The patient was given a 1-month 'trial' of conjugated estrogens, 2.5 mg daily, and 3 months later was found to be pregnant. Although these authors theorized a possible relationship between the estrogen therapy and the subsequent pregnancy, the association may prove to be purely coincidental.

Original languageEnglish (US)
Pages (from-to)500-501
Number of pages2
JournalFertility and sterility
Volume28
Issue number4
DOIs
StatePublished - Jan 1 1977

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ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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