Causes of Premature Ovarian Failure: Understanding the Risks

The ovaries play a key role in reproduction. A girl is born with millions of follicles in her ovaries. After puberty, some of these follicles will mature and release an egg. Without the release of a healthy egg, natural conception is very difficult. Normally the ovaries function until menopause. However, in some cases, they may stop functioning earlier. This is known as a premature ovarian failure. In such cases, the ovaries will no longer release an egg and the woman will no longer have regular periods. This can result in infertility.

Premature ovarian failure can affect women at a much younger age than expected. Dr Shalini, Fertility Specialist at Nova IVF, Prayagraj, explains that some patients in their late 20s or early 30s may have very low ovarian reserve, identified through tests such as AMH and AFC. The condition may be linked to lifestyle or genetic factors. Proper counselling is important to help patients understand what is happening and reduce anxiety. Treatment may include appropriate HRT for associated symptoms. When pregnancy is being planned, IVF may be considered and, in some cases, a donor oocyte programme may be recommended. Diagnosis should be confirmed before treatment begins.

Causes of Premature Ovarian Failure

Some of the causes of premature ovarian failure include:

Genetic Disorders

Genetic disorders are a common cause of premature ovarian failure. Mosaic Turner's syndrome is one such genetic disorder. Women with this syndrome, instead of having two healthy X chromosomes, will have one healthy X chromosome and an altered second X chromosome.
Another genetic disorder that can cause this condition is fragile X syndrome.  Women suffering from this disorder have weak X chromosomes that can break easily.

Exposure to toxins

Many women are diagnosed with premature ovarian failure after being treated with radiation or chemotherapy. Exposure to toxins such as cigarette smoke, pesticides, chemicals and viruses may also cause premature ovarian failure.

Autoimmune Diseases

The immune system works to protect the body against bacteria, viruses and other factors that it perceives as harmful to the body. In rare cases, a person may have an autoimmune disorder that makes the immune system fight against the ovarian tissue. This makes the antibodies it creates attack the follicles containing immature eggs and damages the eggs. This type of autoimmune disorder may be the result of exposure to a virus.

Unknown Causes

In many cases, there may be no identifiable causes of premature ovarian failure. In such cases, the woman may have no chromosomal defects, no exposure to toxins and no autoimmune diseases. This is known as an idiopathic premature ovarian failure.

Risk Factors

Not all women have the same risk of premature ovarian failure. Some of the factors that can increase the risk are:

• Age - Women between the ages of 35-40 years have an increased risk as compared to adolescents.
• Family Medical History - If a woman's mother or any other relatives suffer from premature ovarian failure, she has a high risk of being diagnosed with it as well.
• Multiple Ovarian Surgeries - Conditions such as endometriosis that require repetitive surgery on the ovaries can increase a woman's risk of premature ovarian failure.