Primary Ovarian Insufficiency Nationwide Incidence Rate and Etiology Among Israeli Adolescents

Noah Gruber*, Shir Kugler, Liat de Vries, Avivit Brener, Amnon Zung, Ori Eyal, Marianna Rachmiel, Ilana Koren, Yardena Tenenbaum-Rakover, Eli Hershkovitz, Zohar Landau, Meirav Oren, Alon Eliakim, David Zangen, Alina German, Hussein Majdoub, Kineret Mazor-Aronovitch, Dalit Modan-Moses, Yonatan Yeshayahu, Larisa NaugolniYael Levy-Shraga, Michal Ben-Ami, Gherta Brill, Nehama Zuckerman-Levin, Floris Levy-Khademi, Carmit Avnon-Ziv, Dov Tiosano, Shira Harel, Einat Kedem, Anat Segev-Becker, Yehuda Shoenfeld, Orit Pinhas-Hamiel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Purpose: The aim of the study was to estimate the current incidence and the distribution of etiologies of primary ovarian insufficiency (POI) in a nationwide study. The prevalence of POI in young adult women has recently increased, but the data cited for adolescents are more than three decades old. Methods: Data regarding females aged <21 years diagnosed with POI during the years 2000–2016 were collected from all the pediatric endocrinology units in Israel. POI was defined by at least 4 months of amenorrhea in association with menopausal levels of follicle-stimulating hormone. Iatrogenic cases were excluded. Results: For the 130 females aged <21 years included in the study, the distribution of POI etiologies was Turner syndrome/mosaicism in 56 (43%), idiopathic in 35 (27%), and other (developmental, genetic, metabolic, adrenal, and autoimmune) in 39 (30%) females. During the years 2009–2016, compared with 2000–2008, the incidence rate of new POI diagnoses per 100,000 person-years doubled (4.5 vs. 2.0; p value <.0001), and incidence rates of idiopathic and other etiologies increased by 2.6 (p value =.008) and 3.0 (p value =.002), respectively. In contrast, the incidence of Turner syndrome was constant (p value =.2). In the age group of 15–21 years, the current incidence of non-Turner POI in adolescents is one per 100,000 person-years. Conclusions: In this nationwide study, the incidence rate of POI in youth aged <21 years was one tenth of the rate that is commonly cited. A significant increase in the rate of POI in non-Turner females was observed over the last decade. Contributions of environmental and epigenetic factors should be studied.

Original languageAmerican English
Pages (from-to)603-609
Number of pages7
JournalJournal of Adolescent Health
Issue number5
StatePublished - May 2020

Bibliographical note

Publisher Copyright:
© 2019 Society for Adolescent Health and Medicine


  • Adolescence
  • Amenorrhea
  • Hypergonadotrophic hypogonadism
  • Primary ovarian insufficiency
  • Turner syndrome
  • incidence


Dive into the research topics of 'Primary Ovarian Insufficiency Nationwide Incidence Rate and Etiology Among Israeli Adolescents'. Together they form a unique fingerprint.

Cite this