Women are born with 1,000,000 ova (eggs). Starting from birth, these eggs are consumed at a rate determined by a gene in the X chromosome. When menstruation commences, the number of eggs drops to 400,000-450,000.
Over 20% of these eggs present chromosomal anomalies and 600-1200 eggs are consumed each month. The body consumes good quality eggs first, since these respond easily to hormones, and leaves bad quality eggs for the end of the woman’s reproductive age. Furthermore, the remaining eggs are subjected to the adverse effects of environmental and lifestyle conditions (smoking, radiation, etc.).
This is not new, since it is well-known that pregnant women over 35 years old must undergo extensive prenatal screening due to the greater chance of giving birth to children with Down syndrome or other chromosomal anomalies.
Of course, the age of 35 is not necessarily a milestone for all women, since this represents the mean. So, some women may have severe reduction before the age of 35 and others later.
In premature ovarian failure, the woman does not have eggs to conceive naturally or through IVF. Furthermore, she is also dealing with overall health issues, due to a drop in oestrogen levels. Such issues include osteoporosis, hot flushes, reduced sex drive, sleeplessness, and other symptoms that vary from woman to woman.
Premature ovarian failure may be due to natural factors (heredity, syndromes) or it can be the result of medical intervention (removal of the ovaries due to cancer, radiotherapy, chemotherapy) or immune disorder (systemic lupus erythematosus).
A timely diagnosis and hormone replacement therapy are important to prevent some consequences, such as osteoporosis.
The diagnosis of ovarian failure or, more accurately, the assessment of ovarian reserves can be made with a combination of ultrasound screening and testing the levels of Anti-Mullerian Hormone (AMH) in the blood (simple blood test).