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)