Can you explain the autoimmune theory as a cause of premature ovarian failure? What do you think of this theory? What are your suggestions for treatment? Do you know of any current research in this area?

I.V.

The immune system, which protects your body from infection, relies on a feature called self-recognition -- the ability to distinguish the body's own cells from foreign invaders. Occasionally the immune system is unable to make this distinction, and it mistakenly attacks your own tissue. This sort of autoimmune attack usually involves the production of antibodies against your own cells. If the antibodies are directed against your ovaries, you may develop ovarian inflammation and premature ovarian failure. A blood test can reveal the presence of anti-ovarian antibodies. These may appear in women who are experiencing premature ovarian failure, younger women with elevated levels of the hormone FSH, and women who have experienced a poor response to ovulation induction.

There are few published studies about treating patients who have these antibodies. These early studies used high-dose steroids for a 16-day treatment. Unfortunately, the initial research reports only a few cases where treatment was successful and the women conceived. Sufficient numbers of patients have not been treated to allow us predict the likelihood of success. Also, no studies have been performed using randomized control subjects, which is required to determine if a particular treatment really makes a difference. If your anti-ovarian antibody level is positive, you may wish to review the risks and benefits of steroid treatment with your physician. For now, however, the gold standard of therapy is still to use donated eggs and in vitro fertilization (IVF) to achieve a pregnancy.