Today at New Hope Fertility Center as part of our POF Series of Discussions, we will be discussing Primary Ovarian Insufficiency and some of the ways it is treated.
A woman who has Primary Ovarian Failure (POF) will have a low ovarian reserve, may have trouble producing eggs, and may have irregular periods. Some women with POF are prescribed birth control pills for long periods of time and we would like to discuss the dangers of this.
All women need a hormone that is produced by the brain called FSH (Follicle Stimulation Hormone), which stimulates the follicle to grow.When the woman has a low ovarian reserve, the brain produces a very high level of FSH (around 25%-40%). Having such a high FSH level will cause the follicle to shutdown and will not grow, due to a downregulation of FSH receptors.
To treat high FSH levels, some women are put on birth control pills for prolonged periods of time (3-6 weeks). While birth control may help regulate the levels of high FSH in the ovary, this can cause complete depletion of FSH. If a woman is depleted from FSH, even small follicles will not be recruited.The ovary can be left without any follicles, which is called over-suppression. Giving a woman birth control for a short period of time is sometimes needed, but for a longer period of time we believe this can be extremely dangerous.
Next in our POF series, we will discuss what protocol we use to keep the FSH lower, but not too low, in order to allow the small follicles to be recruited for potential growth.