Progressive decline of residual follicle pool after clinical diagnosis of autoimmune ovarian insufficiency

Summary Context In approximately 5–8% patients with primary ovarian insufficiency (POI), the disease is caused by an autoimmune process made evident by the appearance of autoantibodies against steroidogenic enzymes (SCA‐POI). Anti‐müllerian hormone (AMH) is the best marker of the residual follicular pool. Objective To evaluate the rate of loss of the residual follicle pool in women with SCA‐POI after clinical diagnosis. Design and methods One hundred and thirty‐two women with POI were tested for 21‐hydroxylase autoantibodies, 17α‐hydroxylase autoantibodies and P450scc autoantibodies, and 35 patients with SCA‐POI were identified. AMH was analysed at the time of the first visit in all women with POI, and in follow‐up, serum samples were taken 1–3 years after in 11 women with SCA‐POI and detectable AMH. Results 12/35 (35%) women with SCA‐POI had AMH levels within the normal range at the time of first sampling, as compared to 6/97 (6%) with idiopathic POI (P