Almost every woman dreams of being a mother at some point. My patient had that dream too. But unfortunately, pregnancy is almost impossible for her.
She came to my clinic complaining of one or two days of menses for the past year. She is a fit young lady in her 30s. She's bubbly and full of life. I feel so comfortable talking to her, although that was the first time she came. She got married a few months back and looks forward to having a family. I examined her. There was nothing unusual. A pelvic ultrasound scan showed a normal uterus and ovaries. I gave her medicine to induce her menses and ran some blood work.
FSH 101 --- this is not good. It is way too high. This result indicates that she has a condition called premature ovarian failure. This happens when a woman's ovaries stop working normally before she is 40. This means she will no longer have menses, and she won't be able to get pregnant - she has menopause.
Despite working in OBGYN for many years, breaking bad news never got any easier. I called her to inform the result. I broke the bad news. There was silence a the end of the line. I don't know what to say. As she cried, I offered her word of comfort and support, but it will not change the situation. I know she is devastated; the diagnosis will change her life forever.
Premature ovarian failure affects 1 in 10 women before the age of 40. Most of the time, the cause of this condition is unknown. Some are related to autoimmune diseases or chromosomal disorders. Although technically, these women are in a state of menopause, reports have said that ovarian function can resume, and about 5% of women with this condition got pregnant.
Reference: https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Management-of-premature-ovarian-insufficiency
Once this condition has been diagnosed, the aim is to replace what's lost, i.e. hormone replacement therapy. Further investigation may be needed to exclude chromosomal conditions that may affect other family members.
I pray the best for her and I hope she will pull through this.
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