21. Entrez-PubMed Abstract, A Novel mutation in the FSH receptor inhibiting signal transductionand causing primary ovarian failure. J Clin Endocrinol Metab. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Link&db=PubMed&dbFrom=PubMed&f

22. FDA Drug Approvals List  August 1998 vasomotor symptoms associated with menopause; 2. Vulvar and vaginal atrophy; and3. Hypoestrogenism due to hypogonadism, castration or primary ovarian failure. http://www.fda.gov/cder/da/da0898.htm

Drug Approvals for August 1998 Definitions and Notes August 1998 Original New Drug Applications Original Application #: Approval Date: 26-AUG-98 Trade Name: VITRAVENE Chemical Type: Therapeutic Potential: P Dosage Form: INJECTABLE Applicant: ISIS PHARMACEUTICALS INC Active Ingredient(s): FOMIVIRSEN SODIUM OTC/RX Status: RX Indication(s): Local treatment of cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS) who are intolerant of or have a contraindication to other treatment(s) for CMV retinitis or who were insufficiently responsive to previous treatment(s) for CMV retinitis Original Application #: Approval Date: 26-AUG-98 Trade Name: PROSOL 20% IN PLASTIC CONTAINER Chemical Type: Therapeutic Potential: S Dosage Form: INJECTABLE Applicant: BAXTER HEALTHCARE CORP Active Ingredient(s): AMINO ACIDS OTC/RX Status: RX Indication(s): (1) As an adjunct in the offsetting of nitrogen loss or in the treatment of negative nitrogen balance in patients where: the alimentary tract cannot or should not be used; gastrointestinal absorption of protein is impaired; or metabolic requirements for protein are substantially increased, as with extensive burns; (2) To reduce fluid intake in patients who require both fluid restriction and total parenteral nutrition (TPN) Original Application #: Approval Date: 24-AUG-98 Trade Name: LAMICTAL Chemical Type: Therapeutic Potential: S Dosage Form: TABLET,CHEWABLE DISPERSIBLE

23. Ogen Indications Ogen Dosage Estropipate - RxList Monographs atrophy. 3. Treatment of hypoestrogenism due to hypogonadism, castrationor primary ovarian failure. 4. Prevention of osteoporosis. http://www.rxlist.com/cgi/generic/ogen_ids.htm

Estropipate Health News Please, take our 1 second survey! SEASONAL DEPRESSION MENTAL HEALTH ... WEIGHT LOSS INDICATIONS Estrogen drug products are indicated in the: 1. Treatment of moderate to severe vasomotor symptoms associated with the menopause. There is no adequate evidence that estrogens are effective for nervous symptoms or depression which might occur during menopause and they should not be used to treat these conditions. 2. Treatment of vulval and vaginal atrophy. 3. Treatment of hypoestrogenism due to hypogonadism , castration or primary ovarian failure. 4. Prevention of osteoporosis. Since estrogen administration is associated with risk, selection of patients should ideally be based on prospective identification of risk factors for developing osteoporosis. Unfortunately, there is no certain way to identify those women who will develop osteoporotic fractures. Most prospective studies of efficacy for this indication have been carried out in white menopausal women, without stratification by other risk factors, and tend to show a universally salutary effect on bone. Thus, patient selection must be individualized based on the balance of risks and benefits. A more favorable risk/benefit ratio exists in a hysterectomized woman because she has no risk of

24. Premarin Indications Premarin Dosage Estrogens Conjugated - RxList Monographs 4. Hypoestrogenism due to hypogonadism, castration, or primary ovarian failure. FemaleCastration or primary ovarian failure 1.25 mg daily, cyclically. http://www.rxlist.com/cgi/generic/conest_ids.htm

Estrogens Conjugated Health News Please, take our 1 second survey! SEASONAL DEPRESSION MENTAL HEALTH ... WEIGHT LOSS INDICATIONS Tablets Conjugated estrogens tablets are indicated in the treatment of: Moderate to severe vasomotor symptoms associated with the menopause. There is no adequate evidence that estrogens are effective for nervous symptoms or depression which might occur during menopause and they should not be used to treat these conditions. Atrophic vaginitis. Osteoporosis (loss of bone mass). The mainstays of prevention and management of osteoporosis are estrogen and calcium; exercise and nutrition may be important adjuncts. Estrogen replacement therapy is the most effective single modality for the prevention of osteoporosis in women. Estrogen reduces bone resorption and retards or halts postmenopausal bone loss. Case-controlled studies have shown an approximately 60-percent reduction in hip and wrist fractures in women whose estrogen replacement was begun within a few years of menopause. Studies also suggest that

25. Definition: Recombinant FSH Form Subcutaneous or intramuscular injection. Indications Demonstrated ovulatorydysfunction with No current pregnancy; No evidence of primary ovarian failure; http://sharedjourney.com/define/rfsh.html

Recombinant FSH (rFSH) Classification: human recombinant follicle stimulating hormone (FSH) Brand Names: Follistim® (mfg. Organon), Puregon® (mfg. Organon), Gonal-F® (mfg. Serono) Form: Subcutaneous or intramuscular injection Indications: Demonstrated ovulatory dysfunction with: No current pregnancy No evidence of primary ovarian failure No uncontrolled thyroid or adrenal dysfunction No ovarian cysts (except in case of PCOS) Used in conjunction with hCG Used for: In women, inducing ovarian follicular growth and maturation. May be particularly useful for women with PCOS How does it work? Possesses hormonal activities of follicle stimulating hormone (FSH). Suggested Evaluations: Pre-RX: thyroid disease ovarian enlargement or cyst formation uterine fibroid tumors undiagnosed unusual vaginal bleeding estrogen levels primary pituitary or ovarian failure or enlargement evidence of prostate cancer in men testicular failure renal and hepatic functions During RX: mid-cycle urine LH test (OPK) estrogen levels progesterone levels mid-cycle ultrasound to detect follicle development Usual Dosage: Dosage must be carefully determined for each patient, and may be changed during treatment cycle.

26. ANZJM Vol. 30 No. 1 February 2000 - Editorials Fertil Steril 1995; 64 7405. Coulam CB. The prevalence of autoimmunedisorders among patients with primary ovarian failure. Am http://www.racp.edu.au/anzjm/fe00ed3.htm

Vol. 30 No. 1 February 2000 Editorials X chromosome defects and premature ovarian failure Communications to: Research Centre in Reproductive Medicine, Department of Obstetrics and Gynaecology, National Women's Hospital, Auckland, New Zealand. Email: a.shelling@auckland.ac.nz Two articles in this issue of the Journal by Driscoll et al. ) and McAuley et al ) describe patients with premature ovarian failure (POF) with associated defects on the X chromosome which offer insights into the aetiology of this complex disorder. POF is characterised by secondary amenorrhoea, hypoestrogenism, and elevated gonadotrophins in women under the age of 40 years. It is a common condition and occurs in 1% of women under the age of 40 years, and will affect 0.1% of women before the age of 30 years.( ) POF is becoming a challenging issue for couples, particularly as women delay having families until later in life. Two significant consequences of POF are the loss of fertility, and the clinical effects of hypoestrogenism. Low levels of oestrogen from a young age appear to increase the risk of osteoporosis and coronary heart disease.( POF is clearly a heterogeneous disorder, and only a few causes can be identified.(

27. IVI - Patients And Visitors Route: Oocyte Donation primary ovarian failure; menstruation does not occur during puberty Gonadaldysgenesis (Turner's Syndrome, Swyer's Syndrome, pure gonadal dysgenesis). http://www.ivi.es/english/pacientes/donantesovocitos.htm

Oocyte or ovule donation is an assisted reproduction technique in which a different woman to the one who will receive the oocyte or the resulting embryo supplies the female gamete. The recipient will have a full-term pregnancy and will give birth to the fetus. Female gamete donation was authorized by Spanish legislation in 1988, (35/1988 Act, 22 November). According to this act, maternity will correspond to the woman giving birth to the fetus. Indications for Oocyte Donation Two groups of women are possible candidates for the oocyte donation programme: Content Indications for Oocyte Donation Oocyte Donors Oocyte Recipients Treatment of the Recipient ... The IVI Oocyte Donation Programme Those lacking spontaneous menstruation, due to the menopause, premature ovarian failure, ovarian surgery, and Women who, despite normal menstruation, cannot use their own oocytes, either because of their low quality, hereditary transmittable disorders, or a poor response to ovulation stimulation treatment... All patients with any of the following indications can opt for the Oocyte Donation Programme: 1. Women with ovarian failure, without spontaneous menstruation:

28. GDF-9B/BMP-15 Xlinked mutation that causes increased ovulation rate and twin and triplet birthsin heterozygotes (FecXI/FecX+), but primary ovarian failure in homozygotes http://www.stanford.edu/~ewilhelm/Primary/Oocyte/GDF9-BMP-15.htm

GDF-9B/BMP-15 OKDB#: 8 Symbols: Species: mouse Synonyms: Growth differentiation factor-9B; bone morphogenetic protein-15; BMP15 Related Genes: Sequences human rat mouse other:Other GenBank FASTA GenBank FASTA ... FASTA no link (These links connect to the Genebank and show nucleotide and/or protein sequences of the gene.) Availability of DNA General Comment Like GDF-9, GDF-B belongs to the TGF-beta superfamily having six or more cysteine residues which form a cysteine knot which is characteristic for this family. GDF-9B exhibits 8 cysteine residues in the mature region, however, similar to GDF-9, lacks the cysteine residues thought to be important for covalent dimer formation in other members of this family (Laitinen et al., 1998 ). GDF-9B was also isolated using genomic PCR and named as BMP-15 based on its homology to other BMP proteins (Dube et al., 1998). General function Hormone/growth factor/cytokine Comment Cellular localization Secreted Comment Ovarian function Follicle growth and/or maturation, Steroidogenesis Comment Otsuka F, et al

29. Menopause It occurs in less than 1% of all women. 2,5 There are many reasonsfor amenorrhea in addition to primary ovarian failure. Secondary http://www.clevelandclinicmeded.com/diseasemanagement/women/menopause/menopause.

Published May 29, 2002 Julie Elder, DO Department Obstetrics and Gynecology Holly Thacker, MD Women's Health Center Print Chapter The Cleveland Clinic Foundation DEFINITION Definition Prevalence Pathophysiology Signs and ... References National Guidelines National Osteoporosis Foundation: Osteoporosis Clinical Practice Guideline Menopause is defined as the absence of menses for one year. During this time, estrogen, progesterone and ovarian androgens are diminished due to adult-onset ovarian failure. Women usually experience menopause between 40 and 55 years old, with the median age being 51 for non-smokers. (Figure 1) Smokers and women with chronic illnesses tend to experience menopause at an earlier age (Table 1) Table 1: Factors that Affect the Onset of Menopause Earlier Onset Later Onset Current smoking Nulliparity Pelvic radiation and chemotherapy Medical treatment for depression Genetics Multiparity Increased BMI Higher cognitive scores in childhood Genetics Perimenopause is comprised of fluctuating ovarian function and occurs 2 to 8 years prior to menopause and up to 1 year after the final menses.

30. Human Chorionic Gonadotropin HCG - Infertility Treatment Drugs No evidence of primary ovarian failure; No prior allergic reactionto hCG. Used for In women, inducing ovulation by stimulating the http://infertility.miningco.com/library/ifctr/blhcg.htm

zfp=-1 About Infertility Search in this topic on About on the Web in Products Web Hosting Infertility with Apply Now Your Guide to one of hundreds of sites Home Articles Forums ... Help zmhp('style="color:#fff"') Subjects ESSENTIALS Answers to Frequently Asked Questions How Tos Center for Resolutions to Infertility ... All articles on this topic Stay up-to-date! Subscribe to our newsletter. Advertising Free Credit Report Free Psychics Advertisement Human chorionic gonadotropin (hCG) Classification: chorionic gonadotropin Brand Names: Profasi® (mfg. Serono), Pregnyl® (mfg. Organon), Novarel® (mfg. Ferring), A.P.L.® (mfg. Wyeth-Ayerst) Form: Intramuscular injection Indications: Demonstrated ovulatory dysfunction with: Pre-treatment by human menotropins or follitropins No evidence of primary ovarian failure No prior allergic reaction to hCG Used for: In women, inducing ovulation by stimulating the release of the egg from the follicle. In men, used to treat hypogonadism. How does it work? In women, behaves like luteinizing hormone (LH) to assist the corpus luteum in releasing progesterone, which is crucial to preparation of uterine lining for implantation. In men, stimulates Leydig (interstitial) cells of the testes to produce androgens (testosterone). Suggested Evaluations: Pre-RX: ovarian enlargement or cyst formation uterine fibroid tumors undiagnosed unusual vaginal bleeding estrogen levels primary pituitary or ovarian failure or enlargement evidence of prostate cancer in men During RX: mid-cycle urine LH test (OPK) estrogen levels

31. Pregnyl®-Prescribing Information of ovulation and pregnancy in the anovulatory, infertile woman in whom the causeof anovulation is secondary and not due to primary ovarian failure, and who http://www.organoninc.com/pi/pregnyl_pi.html

Pregnyl (medical) Pregnyl (consumer) (chorionic gonadotropin for injection, USP) DESCRIPTION Human chorionic gonadotropin (HCG), a polypeptide hormone produced by the human placenta, is composed of an alpha and a beta sub-unit. The alpha sub-unit is essentially identical to the alpha sub-units of the human pituitary gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as to the alpha sub-unit of human thyroid-stimulating hormone (TSH). The beta sub-units of these hormones differ in amino acid sequence. CLINICAL PHARMACOLOGY The action of HCG is virtually identical to that of pituitary LH, although HCG appears to have a small degree of FSH activity as well. It stimulates production of gonadal steroid hormones by stimulating the interstitial cells (Leydig cells) of the testis to produce androgens and the corpus luteum of the ovary to produce progesterone. Androgen stimulation in the male leads to the development of secondary sex characteristics and may stimulate testicular descent when no anatomical impediment to descent is present. This descent is usually reversible when HCG is discontinued. During the normal menstrual cycle, LH participates with FSH in the development and maturation of the normal ovarian follicle, and the mid-cycle LH surge triggers ovulation. HCG can substitute for LH in this function. During a normal pregnancy, HCG secreted by the placenta maintains the corpus luteum after LH secretion decreases, supporting continued secretion of estrogen and progesterone and preventing menstruation. HCG HAS NO KNOWN EFFECT ON FAT MOBILIZATION, APPETITE OR SENSE OF HUNGER, OR BODY FAT DISTRIBUTION.

32. The Survival Guide To Obstetrics & Gynaecology Primary or secondary Amenorrhoea or oligomenorrhoea - Physiological pregnancylactation menopause - Pathological primary ovarian failure secondary ovarian http://www.fleshandbones.com/guides/obgyn.cfm

Log in Register now You are here: Home Survival Guides Author: Nicola Campbell What's it all about? Conditions you will be asked about in your first week Abnormal vaginal bleeding Pre-eclampsia Do's and don'ts History and Examination Printer-friendly version (requires Adobe Acrobat) What's it all about? The doctor is usually both an obstetrician and a gynaecologist, although some have special interests and some sub-specialise further. There are overlaps between the two subjects, but essentially obstetrics is the science of pregnancy, and gynaecology is female reproductive medicine. In the course of obstetrics and gynaecology, you might also cover sexual health more widely, areas such as male reproductive health and infertility. The practice of obstetrics and gynaecology includes outpatient clinics, inpatients, theatre, assisting with deliveries and possibly some postnatal and neonatal care. Conditions you will be asked about in your first week Abnormal vaginal bleeding In considering abnormal vaginal bleeding here, we will not cover bleeding during diagnosed pregnancy. Definitions Primary amenorrhoea Failure to start menstruating (by 16 years) Secondary amenorrhoea Lack of menstruation for >6 months (not due to pregnancy) Oligomenorrhoea Infrequent periods, >42-day cycle

33. CombiPatch® vasomotor symptoms associated with menopause; vulvar and vaginal atrophy; and hypoestrogenismdue to hypogonadism, castration, or primary ovarian failure. http://www.combipatch.com/consumers/

For women who still have a uterus, hormone replacement therapy (HRT) works by supplementing the declining levels of estrogen and progesterone in your body. HRT reduces or eliminates the symptoms of menopause such as hot flashes and associated sleep disturbances. Estrogen is the hormone that reduces hot flashes and other symptoms. Progestin (synthetic form of progesterone) is included because estrogen therapy alone causes the lining of the uterus to grow, and can increase the risk of endometrial cancer. The progestin in HRT keeps the lining from growing too much, and reduces this risk. CombiPatch is a unique hormonal replacement therapya combination patch containing both estrogen and a progestin. It is the first combination transdermal therapy system approved for marketing by the FDA. Benefits of estrogen replacement therapy include menopausal symptom control. For women who have not had a hysterectomy, estrogen replacement therapy has been associated with an increased risk of uterine cancer. The CombiPatch addresses this situation with the addition of progestin. Using both hormones together has been shown to reduce the risk of endometrial cancer, while continuing to produce the benefits of estrogen replacement therapy.

34. Not Ovulating (Anovulation) 3. Ovary; Premature ovarian failure (POF); Ovarian failure = menopause;primary ovarian failure (often a chromosomal problem); Secondary http://www.babymed.com/docs/english/121.asp

Membership SHOPPING QuickPoll New 1/18! Charting Charts Display BBT Info Pregnancy Charts ... Testimonials Fertility The 7 BabySteps Fertility Program Reminders Calendars Fertility Pregnancy Chinese Gender Tools ... Help Contact About Us Feedback Privacy Terms Existing Members: Sign In Here New Members: Register Here Current Visitors Home Tools Topics Community ... Help Not Ovulating (Anovulation) Why would I not ovulate? Q: I have very long menstrual cycles and my period often doesn't come for several months. Now my menstrual period hasn't come for 3 months. What could it be? A: Irregular long cycles are called Oligomenorrhea" , and having no period is called Amenorrhea . Besides pregnancy, the major reason why women miss their period or why they have irregular menstrual cycles, and why they can't get pregnant, is Anovulation When you have irregular long cycles and when you don't know whether you ovulate or not, the the first step is to actually find out if you are ovulating or not Once the diagnosis of anovulation is made, your doctor needs to examine you and do some tests to find out the possible causes.

35. Ferring Pharmaceuticals - Fertility Products of ovulation and pregnancy in the anovulatory, infertile woman in whom the causeof anovulation is secondary and not due to primary ovarian failure and who has http://www.ferringusa.com/fertility_products/insert_novarel.htm

Home Contact Overview of Products Bravelle Information ... Infertility Overview 45761B /Revised: May 2001 TABLE OF CONTENTS Description Clinical Pharmacology Indications and Usage Contraindications ... How Supplied DESCRIPTION: Human chorionic gonadotropin (HCG), a polypeptide hormone produced by the human placenta, is composed of an alpha and a beta sub-unit. The alpha sub-unit is essentially identical to the alpha sub-units of the human pituitary gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as to the alpha sub-unit of human thyroid-stimulating hormone (TSH). The beta sub-units of these hormones differ in amino acid sequence. Chorionic gonadotropin is obtained from the human pregnancy urine. It is standardized by a biological assay procedure. chorionic gonadotropin for injection, USP is available in multiple dose vials containing 10,000 USP Units with accompanying Bacteriostatic Water for Injection for reconstitution. When reconstituted with 10 mL of the accompanying diluent each vial contains: Chorionic gonadotropin 10,000 Units

36. King Pharmaceuticals Inc. - Product View Treatment of vulval and vaginal atrophy. Treatment of hypoestrogenismdue to hypogonadism, castration or primary ovarian failure. http://www.kingpharm.com/product_view.asp?KP_Product_ID=91

37. Medscape Www.medscape.com between premature menopause (256.31) and other ovarian failure (256.39), which includesdelayed menarche, ovarian hypofunction, and primary ovarian failure NOS http://www.medscape.com/viewarticle/423559_print

38. Staten Island University Hospital Breast Cancer Protocols adjuvant chemotherapy with the combination of cyclophosphamide, methotrexate,fluorouracil (CMF) undergo permanent primary ovarian failure or menopause. http://www.siuh.edu/bcprotocol.shtml

BREAST CANCER PROTOCOLS Protocols available for breast cancer treatment range from cancer prevention to early-stage adjuvant treatment to treatment of advanced stage disease. Study Title: A PHASE III CLINICAL TRIAL COMPARING 3 COMBINATIONS OF ADJUVANT CHEMOTHERAPY: EC+FILGRASTIM+EPOETIN ALFA FOLLOWED BY PACLITAXEL VERSUS AC FOLLOWED BY PACLITAXEL VERSUS CEF IN PREMENOPAUSAL AND EARLY POSTMENOPAUSAL WOMEN WHO HAVE HAD SURGERY FOR AXILLARY NODE POSITIVE OR HIGH-RISK NODE NEGATIVE BREAST CANCER. Background and Rationale: Inclusion/ Exclusion criteria: Patients must be women with breast cancer who are 60 years of age or less, who were found to have positive (tumor-involved) axillary nodes or were found to be node- negative, but have features associated with a higher risk for recurrence. Patients must have adequate blood counts, and adequate kidney and liver function. Patient cannot be pregnant, lactating or unwilling to use effective contraception while on study. Patient cannot have significant pre-existing medical or psychiatric conditions, including history of heart disease. Patient cannot have had prior therapy for breast cancer Patient cannot be pregnant, breast-feeding or unwilling to use effective contraception while on study.

39. Business Opportunity - Patient Reimbursements 255.0 Cushing Syndrome *256.2 Post Oblative Ovarian Failure Age 40 and below *256.3primary ovarian failure - Age 40 and below 256.30 Premature Osteoporosis http://www.bonedensitometry.com/reimbursement1.htm

Business Opportunity -Patient reimbursement OSTEOPOROSIS BONE DENSITOMETRY ''For better prevention, detection diagnosis and treatments of Osteoporosis'' Bone Densitometry for Osteoporosis Detection -Fee Per Scan -No Investment Required -Free Equipment Placement -Free Ongoing Training Preowned Equipment Coming Off Leases List of Available Preowned Equipment Lunar Hologic Norland ... Schick Fee Per Scan Leasing Program Why's bone densitometry needed? Executive summary Key points about program Densitometry equipment needed ... Patient reimbursements About MEC/OBD Our mission Setting up your practice Developing outreach programs About Bone Densitometry Different techniques More on reimbursements FAQs on DXA vs. ultrasound Operator requirements About Osteoporosis Basic facts Prevention guidelines Treatment guidelines Links to other web sites Web Site Navigation Goto home page Search web site Info request email form MEC Contact Info Website: bonedensitometry.com Email: info@bonedensitometry.com Phone: 1-888-999-4774 Fax: 1-419-628-4005 REIMBURSEMENT CODES FOR BONE DENSITOMETRY The new Balanced Budget Amendment, signed into law, mandates preventative care for high risk individuals, and guarantees Bone Density Reimbursement even if the test is negative and also requires all states to pay for the codes below starting July 1998.

40. Anovulation : Causes And Diagnosis PRL may be increased with drugs (major tranquillisers). III Ovary Ovarianfailure = menopause. primary ovarian failure is often chromosomal. http://members.iinet.net.au/~mmckenna/~ANOV.html

West Australian Obstetrics and Gynaecology Learning Resources Anovulation and Ovulation Ovulation and Anovulation. Consider the following questions. If you can answer them then you have sufficiently mastered this material What happens if there is anovulation? How can we tell if ovulation is occurring? What causes are there for anovulation? How do I find the cause for anovulation? ... How to I treat someone with anovulation? What happens if there is anovulation? Normal Ovulation has estradiol rise in the follicular phase followed by progesterone and estrogen production in the luteal phase. Normal menstrual bleeding is caused by progesterone withdrawal. Anovulation may be associated with no follicular development and so no estrogen production; or there may be some follicular development but no progression to ovulation with estrogen production but no progesterone rise. Anovulation is associated with: - difficulty getting pregnant - no or few periods if the estrogen is low - bone loss, menopausal symptoms if the estrogen is very low - heavy, infrequent or frequent periods if estrogen is present without progesterone

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