How is premature ovarian failure diagnosed?

Premature ovarian failure needs attention and conditioning, but some people do not understand the problem of premature ovarian failure. It is recommended to pay attention to some examinations to understand the size of the ovaries and whether there are follicles. Now B-ultrasound examinations and endocrine hormone tests can provide information.

1. Physical signs:

High baseline basal body temperature. Gynecological examination showed that the vaginal mucosa was thin, with few wrinkles, congestion, and uterine atrophy.

2. Laboratory and other examinations:

1. Endocrine hormone testing: FSH and LH levels are significantly increased, and E2 levels are significantly decreased, both reaching menopausal levels. A diagnosis can only be made after three tests. Blood PRL is normal.

2. Vaginal exfoliated cells: show low estrogen levels, with the presence of bottom-layer cells or mainly bottom-layer cells.

3. Laparoscopic examination or laparotomy of ovarian biopsy: In patients with premature ovarian failure, the ovaries are small and atrophic, the follicles are not obvious, no primordial follicles are seen under the microscope, the ovarian stroma is fibrotic, and anti-ovarian antibodies can be found in the ovaries. In patients with unresponsive ovary syndrome, the ovaries are normal in size, and multiple small follicles can be seen both with the naked eye and under the microscope. Anti-theca cell, anti-granulosa cell, and anti-FSH antibodies can be found in the ovarian tissue.

4. Laboratory examination of premature ovarian failure

The chromosome karyotype is 46, xx. The blood estrogen level is low (usually less than 20pg/ml), the blood FSH and LH are increased, and FSH rises earlier and higher than LH. Blood prolactin was normal. Estrogen withdrawal blood test is often positive. If ovarian biopsy finds that there are still follicles, it may be that the ovaries lack FSH receptors and lack response to gonadotropin. This situation is called ovarian insensitivity syndrome. Because ovarian insensitivity syndrome is rare and the chance of pregnancy is very small, ovarian biopsy is generally not recommended. If conditions permit, ovarian tissue antibodies and anti-adrenal cortex antibodies can be tested to detect related autoimmune diseases.

3. B-ultrasound:

If the ovaries are small and no follicles are seen, it is premature ovarian failure; if the ovaries are normal in size and multiple small follicles are seen, it is unresponsive ovary syndrome.