METHODS: A 27-year-old female visited an outpatient department for premature ovarian insufficiency (POI) and infertility. She had regular menstrual periods since she was 14 years old and had no history of systemic disease. Laboratory tests showed low estrogen (15 ng/L, range 19.6-144.2 ng/L), elevated follicle-stimulating hormone (34 U/L), low anti-Mullerian hormone (0.1 μg/L), normal prolactin (11.48 ng/mL), and thyroid stimulating hormone (TSH) levels (0.97 mU/L). She demonstrated smaller bilateral ovarian volume and positivity to antinuclear and antiphospholipid antibodies. After the failure of conventional drug therapy and in vitro fertilization, the patient became pregnant naturally after treatment with glucocorticoids.
CONCLUSIONS: Immunosuppression could help improve ovarian function and pregnancy outcomes in POI patients, but the therapeutic mechanisms are not clear and should be elucidated with more clinical studies.
方法:一名27岁女性因卵巢早衰(POI)和不孕症就诊于门诊。她从14岁开始有规律的月经周期,没有全身性疾病史。实验室检查显示雌激素低(15ng/L,范围19.6-144.2ng/L),促卵泡激素升高(34U/L),低抗苗勒管激素(0.1μg/L),正常催乳素(11.48ng/mL),促甲状腺激素(TSH)水平(0.97mU/L)。她表现出较小的双侧卵巢体积和抗核抗体和抗磷脂抗体阳性。常规药物治疗和体外受精失败后,患者在接受糖皮质激素治疗后自然怀孕.
结论:免疫抑制有助于改善POI患者的卵巢功能和妊娠结局。但治疗机制尚不清楚,应通过更多的临床研究来阐明。