P-53: The Unexpected Occurrence of SpontaneousPregnancy during Hormone ReplacementTherapy for Premature Ovarian Failure

Background: Premature ovarian failure (POF) is defined by the association of amenorrhea, hypoestrogenism and elevated (menopausal) levels of serum gonadotropins before age of 40 years-old. This condition affects approximately %1 of women under 40 years of age. Physiologic replacement of ovarian steroid hormones seems rational until the age of normal menopause. Temporary return of ovarian function, as indicated by elevated estrdiol levels, and follicle development may occur in this condition. Spontaneous Pregnancy is a very rare event in the patients with POF. The choicetherapeutic protocol for infertility treatment is IVF program with egg donation. We report a case of POF who conceived spontaneously during hormone replacement therapy. Materials and Methods: An infertile 30 years-old woman was presented with confirmed premature ovarian failure after pelvic surgery ( Serum FSH levels in range of 62-135 IU/ L, LH levels in range of 34.8-88IU/ L ,Progesterone level 0.3ng/m L, and those of estrdiol less than 10pg/ m L) on hormone replacement therapy, who conceived. She is currently in second trimester (23weeks) of an uneventful pregnancy. Results: Despite having ovarian failure and receiving hormone replacement therapy, the patient spontaneously conceived. Conclusion: Return of ovarian function and achievement of pregnancy is possible in infertile women with premature ovarian failure. Women who wish to avoid pregnancy should use proper contraceptive methods.