ABSTRACT
OBJECTIVES: Recently, it was suggested that apoptosis may be a basic mechanism of follicular atretic process. If the POF(premature ovarian failure) results from an acceleration of the process of atresia of the oocytes causing premature deletion of stored oocytes, POF may be a good model for the apoptosis. Our objective is to determine the relation between the POF and apoptosis. METHODS: We performed laparoscopic ovarian biopsy in 17 patients with POF. We evaluated the ovaries from a patient with POF by conventional H-E stining and immunohistochemical staining for apoptosis related protein(bcl-2, bax, fas and fas-L). RESULTS: Atretic cystic follicles were seen 4 out of 17 patients, and corpora albicans indicating past ovulation were seen 9 out of 17 patients. Primordial follicles were seen in 3 out of 17 patients, however developing follicles were not seen in all patients. Immunohistochemical analysis revealed that Bax was expressed in the lining cells of the atretic cystic follicle and primordial follicle and mesothelial cells lining the surface of the ovary. Fas and Fas-L were expressed on the lining pregranulosa cells and primary oocyte of the primordial follicle in the ovary of the patient with premature ovarian failure. Bax were also expressed on the lining pregranulosa cell and oocyte of the premature ovarian failure. Bcl-2 was expressed in the lining cells of primordial follicles of the patients with POF. CONCLUSION: Apoptosis may be a basic mechanism of POF. Bax, fas and fas-L may play a role causing premature follicular depletion.