Premature Ovarian Failure Diagnosis
POA diagnosis is important not only for a patient’s fertility prospect but also for her whole-body health. The diagnosis of premature ovarian failure (POF) is made based on a blood test for follicle-stimulating hormone (FSH). Patients with FSH levels above 40.0 mIU/mL (a post-menopausal level) are diagnosed with POF, while patients with elevated FSH levels that do not exceed this threshold should be diagnosed with premature ovarian aging (POA).
We've helped many women who were misdiagnosed with POF get pregnant with their own eggs.
Unfortunately, POF is commonly misdiagnosed. We find that many patients who come to us with an ovarian failure diagnosis actually are suffering from premature ovarian aging (POA), a treatable cause of infertility.
While these two conditions sound similar, correct distinction between POF and POA is crucial. Women with POA can often get pregnant using their own eggs. In fact, CHR physicians and other reports in the medical literature show remarkably good pregnancy results in women with even severe POA (especially with DHEA supplementation and proactive ovarian supplementation and proactive ovarian stimulation). However, for women with a true POF diagnosis, the chances of pregnancy with their own eggs remain quite small. Pregnancy attempts in POF, therefore, always involve experimental POF treatments, as no effective fertility treatment has so far been established for POF patients.
Premature Ovarian Insufficiency/Failure Symptoms
POF, which is sometimes called premature ovarian insufficiency or primary ovarian insufficiency, has symptoms typical of estrogen deficiency. Common signs of POF/POI include:
- Irregular menses or skipped menses (amenorrhea)
- Hot flashes
- Night sweats
- Emotional/psychological difficulty like irritability and difficulty concentrating
- Vaginal dryness and discomfort during sex.
Ovarian insufficiency symptoms are similar to the symptoms experienced during menopause. Women who experience these premature ovarian failure symptoms should consult their OBGYN or a fertility specialist and undergo POF testing so that treatment to prevent complications like osteoporosis and heart disease can start quickly.
POA and PCOS Misdiagnosis
If you or your physician suspect premature ovarian failure, proper testing is absolutely essential to arrive at a diagnosis. A POF test via FSH at a reputable center, like CHR, will determine whether the cause of infertility is actually premature ovarian failure or a different, more easily-treatable condition (such as premature ovarian aging).
Another condition that patients occasionally confuse with POF is PCOS (polycystic ovary syndrome). This confusion mainly stems from the fact that both POF and PCOS can involve irregular periods or absent menses (amenorrhea). However, PCOS misdiagnosed as POF or vice versa is very rare, once patients consult a physician.Physicians can easily distinguish the two conditions with a simple workup, including an FSH test and ovarian ultrasound.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.