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TABLE 4. Diagnostic protocol for premature ovarian failure.

Evaluation of autoimmune disorders

  • immunologic profile
  • antinuclear antibodies
  • rheumatoid factor
  • complete blood count
  • serum calcium and phosphorus
  • T4 RIA, TSH, antithyroid peroxidase antibodies, antithyroglobulin antibodies
  • thyroid-stimulating antibodies (TSAb)
  • antiovarian antibodies
  • antiadrenal antibodies
  • antigastric mucosa antibodies
  • islet cells antibodies (ICA)

Evaluation of chromosome causes

  • Karyotype
  • DNA analysis of X chromosome

Enzvmatic defects

  • 17a-hydroxylase deficiency (if primary amenorrhea and hypertension)
  • Na, K, Progesterone, DOC

Molecular gonadotropin alterations (a or ß subunit defects)

  • biological assay of LH and FSH

Gonadotropin receptor and/or post receptor defects

  • receptor studies

Ovarian biopsy

Cutaneous biopsy (Werner Syndrome)