PREVALENCE, SPECIFICITY AND SIGNIFICANCE OF OVARIAN ANTIBODIES DURINGSPONTANEOUS PREMATURE OVARIAN FAILURE

Autoimmunity may be involved in idiopathic premature ovarian failure ( POF). However, the frequency, physiopathology and potential reversibil ity of autoimmune oophoritis needs clarification, Using an ELISA again st whole tissue homogenate as antigen, from human ovaries at different ages, positive circulating ovarian antibodies (AOA) were found in 59% of patients with primitive idiopathic POF (27/46); 20/27 were positiv e for IgG isotype, 9/27 for IgM and 8/27 for IgA, Specificity of AOA w as examined (i) by comparison to different control groups; mean values of the three subclasses of immunoglobins were significantly higher in POF women than in normally cycling fertile young women (n = 23) and f ertile young men (It 17), in untreated Grave's disease (n = 35) or in women with positive antinuclear factor (n = 25); and (ii) by assessing possible cross-reaction; only six out of the 27 positive sera reacted with other tissues (thyroid, pancreas, adrenal), including four clini cal polyendocrinopathies. Significance of AOA was explored (i) by comp arison with postmenopausal women (n = 40) and older women (n = 15), wh o did not have enhanced ratios of AOA, thereby excluding a potential r ole of high FSH values; (ii) by analysing the factors time and surgery ; no relation could be found either with the duration of amenorrhoea ( 6 months to 21 years) or with the history of an ovarian biopsy (12/47) in the absence of any associated pelvic surgery; and (iii) by screeni ng for other immunological factors; familial or personal autoimmune di sease (8/46), HLA DR3 (10/42), HLA DR4 (11/42), associated autoantibod ies (thyroperoxidase, adrenal, beta islets, parathyroid, DNA, smooth m uscles) (12/42), If one positive AOA isotype was present, a second imm unological factor was found in 45% of cases, Spontaneous pregnancies d uring oestrogen therapy occurred in four cases, including three women with positive AOA, Circulating AOA detected by an ELISA may represent a practical and suitable marker for diagnosis of POF, Its use for prog nosis and rational treatment needs further evaluation.