Common Causes of Primary Ovarian Insufficiency
Cause | Examples |
|---|---|
Enzyme defects | 17-Alpha-hydroxylase deficiency 17,20-Lyase deficiency |
Genetic defects | Accelerated ovarian follicular atresia (idiopathic) Certain autosomal defects FMR1 premutation (Fragile X syndrome) Gonadal dysgenesis secondary to genetic defects (eg, Turner syndrome [(45,X or mosaic 45,X/46,XX or 45,X/47,XXX]) or mixed gonadal dysgenesis) Idiopathic hypogonadotropic hypogonadism Reduced germ cell number Trisomy X with or without chromosomal mosaicism |
Immune-mediated disturbances | Autoimmune disorders (most commonly, thyroiditis, hypoparathyroidism, myasthenia gravis, vitiligo, pernicious anemia, and mucocutaneous candidiasis) Congenital thymic aplasia Isolated ovarian failure |
Other causes | Secondary adrenal insufficiency Chemotherapeutic (especially alkylating) agents Cigarette smoking Irradiation of the gonads Surgical extirpation of the gonads or adnexa Viral infections (eg, mumps) |