Premature Ovarian Failure-What Causes & Doesn’t Cause
In most cases of Premature Ovarian Failure (also sometime called premature menopause) a definitive cause is never determined. According to Dr. Timothy Hickman with Houston IVF, the following is what we currently know and don’t know about the causes of Premature Ovarian Failure (POF).
4 Known Causes of Premature Ovarian Failure
- There is some evidence that POF may run in families, but the exact genetic connection has not been identified.
- Women with autoimmune diseases are at a higher risk for premature ovarian failure.
- Some chemotherapies and radiation are known causes for POF.
- Women who have only one functioning ovary are at a greater risk for premature ovarian failure.
3 Things That Don’t Cause Premature Ovarian Failure
- The stimulating of the ovaries that occurs in an IVF cycle does not put women at higher risk for premature ovarian failure in the future. (Dr. Hickman did a great job of explaining why on the this week’s Creating a Family show. You can listen below.)
- There is no known link between taking Accutane (a treatment for acne) to POF.
- There is no known link between premature ovarian failure and the HPV vaccines (Gardasil or Cervarix).
2 Possible Causes of POF
Pollution and Environmental Exposures
The jury is still out on whether environmental pollution or chemical exposures in our everyday life contribute to premature ovarian failure. Even though exposures to pollution and chemicals has increased, doctors do not believe that the incidence of POF is increasing. The slope of fertility decline with age has remained about the same since the 1500s. We may be seeing the diagnosis more often, but Dr. Hickman attributes this to women waiting until their 30s to get pregnant.
It is hard to imagine, however, that our exposure to toxins in our environment is not having some impact. Dr. Hickman’s educated guess is that environmental factors play a role in premature ovarian failure. I can’t recommend enough a Creating a Family show we did with Dr. Tracey Woodruff, Director of the Program on Reproductive Health and the Environment at the University of California San Francisco, on How the Environment Affects Fertility and Conception. (I incorrectly said she was with Stanford University on the show.)
Prenatal Conditions and Epigenetics
A female’s egg supply peaks when she is at 20 weeks gestation and declines slowly after birth until she reaches about 30 when the decline picks up. A fascinating area of research is whether pregnancy condition or epigenetics affects the total number of eggs a female start out with at 20 weeks gestation. We simply don’t know the answer, but I suspect we will find out that these play a role as well.
What I so appreciated about our guest expert, Dr. Timothy Hickman, was his forthrightness of what we know and what we don’t know. He didn’t automatically discount possible causes or treatments that we don’t have good research to support. That says a lot in a western trained doctor.
For more information about participating in the IVA Study that was discussed on this show as a possible new treatment for POF, go to the Colorado Center for Reproductive Medicine website.