Dijagnostika i liječenje prijevremene ovarijske insuficijencije

master's thesis

• Title (english): Diagnosis and treatment of premature ovarian insufficiency
• Author: Mia Mihoković
• Mentor: Marina Šprem Goldštajn (mentor)
• Committee member: Dinka Pavičić Baldani (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Marina Šprem Goldštajn (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Prijevremena ovarijska insuficijencija klinički je sindrom koji dovodi do gubitka normalne funkcije jajnika prije 40.godine života. Dijagnoza se postavlja na temelju povišenih vrijednosti FSH u rasponima koji se nalaze u menopauzi otkrivenim u najmanje dva navrata u razmaku duljem od mjesec dana. Učestalost pojave ovog sindroma je 1%. Etiologija je u većini je slučajeva nepoznata i tada se naziva spontana ili idiopatska POI. Etiologija poznatih uzroka može se podijeliti u nekoliko skupina: genetske abnormalnosti, metabolički poremećaji, autoimunost, ijatrogeni uzroci, infekcije i okolišni čimbenici. Zbog manjkave funkcije jajnika, javljaju se amenoreja i simptomi koji nalikuju onima u menopauzi, kao što su napadaji vrućine. Osim na reproduktivni sustav, POI utječe negativno i na urinarni, koštani i kardiovaskularni sustav, te psihološko zdravlje pacijenata. Uz analizu spolnih hormona i detaljnu osobnu i obiteljsku anamnezu, u dijagnostici se koriste i radiološke metode, genetsko testiranje, te testiranje antitijela. U terapiji se na prvome mjestu primjenjuje hormonsko nadomjesno liječenje. Za rješavanje problema plodnosti, može se primijeniti donacija oocita. Kako bi liječenje bolesti bilo sveuobuhvatno, psihološka je potpora također vrlo bitna. Nove metode liječenja uključuju intraovarijsku infuziju plazme bogate trombocitima, terapiju matičnim stanicama, in vitro aktivaciju i razne druge metode i preparate, koje su u fazama testiranja.

Abstract (english)

Premature ovarian failure is a clinical syndrome that leads to the loss of normal ovarian function before the age of 40. The diagnosis is based on elevated FSH values in the menopausal range detected on at least two occasions more than one month apart. The incidence of this syndrome is 1%. In most cases, the etiology is unknown, therefore it is classified as spontaneous or idiopathic POI. The etiology of known causes can be divided into several groups: genetic abnormalities, metabolic disorders, autoimmunity, iatrogenic causes, infections and environmental factors. Due to deficient ovarian function, amenorrhea and menopause-like symptoms occur, such as hot flashes. In addition to the reproductive system, POI also negatively affects bone health, the cardiovascular system, and mental health of patients. In addition to the analysis of sex hormones and a detailed personal and family history, radiological methods, genetic testing, and antibody testing are also used in the diagnosis. The first line of treatment is hormone replacement therapy. Oocyte donation can be used to solve infertility issues. In order for the treatment to be comprehensive, psychological support is also very important. New treatment methods include intraovarian infusion of platelet-rich plasma, stem cell therapy, in vitro activation, and various other methods and substances, which are being tested in numerous trials.

• Keywords: POI; etiologija; dijagnoza; terapija
• Keywords (english): POI; etiology; diagnosis; treatment
• Language: croatian
• URN:NBN: urn:nbn:hr:105:683994
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-26 11:47:59