Can the warm nest recover if it ages prematurely?

After premature ovarian failure occurs, many female friends will feel particularly scared, fearing that they have some serious diseases that lead to this gynecological problem. Moreover, there is no way to completely cure it once it is contracted. Most patients can only achieve appropriate improvement through the medications used in daily life. There is no way to return to the original state and supplement their bodies with some estrogen.

1. Estrogen-progesterone replacement therapy (HRT)

Estrogen-progesterone replacement therapy is very important for young POF patients. It can relieve the symptoms of low estrogen and urogenital tract atrophy (in preparation for donated egg embryo transplantation), prevent long-term complications (osteoporosis, Alzheimer's disease, etc.), and reduce the risk of colon cancer by 37%. However, long-term HRT also has certain risks, such as the occurrence of endometrial cancer and breast cancer. However, studies have shown that estrogen-progesterone replacement therapy with progesterone for more than 10 days per month can reduce the risk of endometrial cancer to almost zero, while slightly increasing the risk of breast cancer, but the mortality rate does not increase. Usually a combination of estrogen and progesterone is used. Before applying HRT, an individualized balance of pros and cons should be made, and necessary monitoring and follow-up should be carried out.

2. Prevent osteoporosis

In addition to HRT, ensure 1200 mg of calcium intake per day. Vitamin D 400-800 IU/day, and engage in necessary physical exercise, such as walking, yoga or Tai Chi.

3. Ovulation induction therapy

There are many successful experiences in inducing ovulation in POF patients in the literature. The conditions for screening patients before treatment are mostly short amenorrhea time, not too high blood FSH level, and clinical diagnosis of follicular POF. Generally, after HRT or GnRHa is used to suppress endogenous gonadotropin (mainly FSH) to a lower level (<20IU/L), sufficient hMG/hCG is given to induce ovulation while ultrasound monitoring is performed. The hMG dosage is required to be large and the duration is long. The theoretical basis for the success of down-regulation in ovulation induction is that after down-regulation, the endogenous FSH level decreases, the number of FSH receptors on the surface of granulosa cells increases, and the sensitivity of the ovaries is increased.

4. Immunotherapy

Because immune factors are a definite cause of premature ovarian failure, immunosuppressive treatment is effective for patients with premature ovarian failure who have evidence of immune factors. Pregnancies have occurred with multiple immunosuppressive therapies. So far, there is no clear method to identify the role of immune factors in POF, nor is there a clear indication for immunotherapy and a standardized medication regimen. Immunosuppressive therapy can cause serious side effects, so blindly using immunosuppressants to treat POF is not recommended clinically.