RESUMEN
A falência ovariana prematura (FOP) acomete aproximadamente 1:1000 mulheres antes dos 30 anos, 1:250 em torno dos 35 anos e de 1:100 aos 40 anos. Manifesta-se como amenorréia primária ou amenorréia secundária, não podendo ser considerada definitiva em todas as pacientes, uma vez que a concepção espontânea pode ocorrer em até 5-10 por cento das FOP. Na maioria dos casos apresenta-se na forma esporádica, pois apenas 5 por cento apresentam história familial. Entre as causas conhecidas estão as alterações cromossômicas, dos genes ligados ao cromossomo X e cromossomos autossômicos, doenças autoimunes, alterações tóxicas e iatrogênicas. Com relativa freqüência, a causa etiológica não é obtida, sendo então denominada de idiopática. O diagnóstico da FOP é feito baseado na história clínica e níveis elevados do hormônio folículo estimulante (FSH), sendo posteriormente investigadas as causas mais específicas. O manejo clínico visa o suporte emocional, o tratamento hormonal com estrogênios e progestogênios, a abordagem da infertilidade e a prevenção de co-morbidades como a osteoporose e potencial maior risco cardiovascular.
Premature ovarian failure occurs in approximately 1:1000 women before 30 years, 1:250 by 35 years and 1:100 by the age of 40. It is characterized by primary or secondary amenorrhea and cannot be considered as definitive because spontaneous conception may occur in 5 to 10 percent of cases. In 95 percent of cases, premature ovarian failure is sporadic. The known causes of premature ovarian failure include chromosomal defects, autoimmune diseases, exposure to radiation or chemotherapy, surgical procedures, and certain drugs. Frequently, however, the etiology is not clear and these cases are considered to be idiopathic. Premature ovarian failure is defined by gonadal failure and high serum follicle-stimulating hormone (FSH) levels. Clinical approach includes emotional support, hormonal therapy with estrogens and progesterone or progestogens, infertility treatment, and prevention of osteoporosis and potential cardiovascular risk.
Asunto(s)
Adulto , Femenino , Humanos , Enfermedades Autoinmunes/complicaciones , Atresia Folicular/genética , Insuficiencia Ovárica Primaria/etiología , Amenorrea/etiología , Biomarcadores/sangre , Terapia de Reemplazo de Estrógeno , Estrógenos/uso terapéutico , Hormona Folículo Estimulante/sangre , Hipogonadismo/etiología , Infertilidad Femenina/etiología , Mutación/genética , Insuficiencia Ovárica Primaria/genética , Insuficiencia Ovárica Primaria/terapia , Folículo Ovárico/anomalías , Progesterona/uso terapéutico , Progestinas/uso terapéutico , Receptores de HFE/genéticaRESUMEN
Numerous models have been developed to study polycystic ovarian syndrome in rats. In the present study, the syndrome was induced by exposure to constant light. The histological structure and differential distribution of extracellular matrix (ECM) fibers as well as the glycosaminoglycans (GAGs) content and composition of the ovarian follicular wall of rats with polycystic syndrome were evaluated. Histochemical differences were observed in the graunlosa and theca externa of follicular cysts when compared to normal preovulatory follicles. The colagen content of the theca externa of follicular cysts, quantified by the picrosirius method, was higher than in the controls. The neural carbohydrate and acidic GAC levels were lower in the granulosa and higher in the theca externa of cyst follicles than in control ovaries. Histomorphometrically, the follicular diameter was both a convenient and appropriate measurement for describing the cyst status; there were no differences in the thickness of each follicular layer. In conclusion, differences in the components of ECM were observed in the follicular wall of ovarian cysts compared eith normal preovulatory follicles. Howere, sinde these changes did not occur uniformly in all layers of the follicular wall, their role in cyst development remains to be established.