This project seeks to improve the clinical care available to patients with disorders of ovarian follicle function and ovulation through research using animal models as well as clinical protocols. In pursuing this goal, we expect to expand understanding of the ovarian follicle in health and disease. We have focused on premature ovarian failure, a condition that prematurely terminates ovarian function and fertility in 1% of women. We have particular interest in autoimmunity as a cause of ovarian failure. In a mouse model, we found that autoantibodies from mice with experimental autoimmune oophoritis bind to a 120 kd protein that is specific to the oocyte cytoplasm. Using this immune serum we identified a novel oocyte-specific gene that may represent the inciting antigen in this disease. In the clinic, we have found that premature ovarian failure is not merely a premature menopause. One half of these young women have ovaries that function intermittently. We successfully treated one woman with histologically proven autoimmune oophoritis under an approved research protocol using low dose prednisone. We have also demonstrated that inappropriate luteinization of graafian follicles is a major pathophysiologic mechanism preventing normal follicle function. We plan to develop therapeutic strategies to prevent this inappropriate luteinization and possibly restore fertility to some of these young women. In a related effort, we are investigating the physiology of the luteinization process in normal fertile women. We are also investigating other adverse health consequences of premature ovarian failure. We found that these young women have deficient circulating free testosterone levels, and, surprisingly, we found that two thirds of our patients have a reduced bone density that may place them at increased risk of hip fracture. Furthermore, we have preliminary findings to suggest that one-third of these young women may have an associated mineralocorticoid deficiency. Premature ovarian failure is clearly a more complex condition than has been previously recognized. We have clinical studies underway to develop hormone replacement methods appropriate specifically to these young women. We have also expanded our efforts to include clinical studies of polycystic ovary syndrome.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Intramural Research (Z01)
Project #
1Z01HD000633-09
Application #
6290185
Study Section
Special Emphasis Panel (DEB)
Project Start
Project End
Budget Start
Budget End
Support Year
9
Fiscal Year
1999
Total Cost
Indirect Cost
City
State
Country
United States
Zip Code
Popat, Vaishali B; Calis, Karim A; Vanderhoof, Vien H et al. (2009) Bone mineral density in estrogen-deficient young women. J Clin Endocrinol Metab 94:2277-83
Hubayter, Ziad R; Popat, Vaishali; Vanderhoof, Vien H et al. (2009) A prospective evaluation of antral follicle function in women with 46,XX spontaneous primary ovarian insufficiency. Fertil Steril :
Kalantaridou, Sophia N; Vanderhoof, Vien H; Calis, Karim A et al. (2008) Sexual function in young women with spontaneous 46,XX primary ovarian insufficiency. Fertil Steril 90:1805-11
McConkie-Rosell, Allyn; Abrams, Liane; Finucane, Brenda et al. (2007) Recommendations from multi-disciplinary focus groups on cascade testing and genetic counseling for fragile X-associated disorders. J Genet Couns 16:593-606
Ventura, June L; Fitzgerald, O Ray; Koziol, Deloris E et al. (2007) Functional well-being is positively correlated with spiritual well-being in women who have spontaneous premature ovarian failure. Fertil Steril 87:584-90
Wittenberger, Michael D; Hagerman, Randi J; Sherman, Stephanie L et al. (2007) The FMR1 premutation and reproduction. Fertil Steril 87:456-65
Armstrong, Alicia Y; Calis, Karim A; Nelson, Lawrence M (2007) Do survivors of childhood cancer have an increased incidence of primary ovarian insufficiency? Nat Clin Pract Endocrinol Metab 3:326-7
Di Pasquale, Elisa; Rossetti, Raffaella; Marozzi, Anna et al. (2006) Identification of new variants of human BMP15 gene in a large cohort of women with premature ovarian failure. J Clin Endocrinol Metab 91:1976-9
Tung, Joyce Y; Rosen, Mitchell P; Nelson, Lawrence M et al. (2006) Novel missense mutations of the Deleted-in-AZoospermia-Like (DAZL) gene in infertile women and men. Reprod Biol Endocrinol 4:40
Corrigan, Emily C; Nelson, Lawrence M; Bakalov, Vladimir K et al. (2006) Effects of ovarian failure and X-chromosome deletion on body composition and insulin sensitivity in young women. Menopause 13:911-6

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