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Two forms have been described: in type I, POF related infertility is an adjunct to the condition, and type II is not associated with POF (55). BPES type I is mapped to 3q22-23(54). Two genes are identified within the breakpoint region. One of the genes, termed FOXL2 appears predominantly in the ovaries of adult humans. In previous reports, all mutations had been exclusively localized in the FOXL2 gene (56). However, two other members of this family, FOXO1A and FOXO3A, are candidate genes for the development of POF (57).

Autoimmune polyendocrinopathy- candidiasisectodermal dystrophy (APECED)

AIRE gene, is responsible for autoimmune polyendocrinopathy- candidiasis-ectodermal dystrophy syndrome (APECED) (53). This mutation, which is mapped to chromosome 21q23, can lead to hypogonadism and ovarian insufficiency (53).

Steroidogenic enzyme defect

Several congenital enzyme defects can disrupt estrogen synthesis; these defects result in low estrogen, delayed puberty, amenorrhea, and high serum FSH concentration levels despite the existence of normal-appearing primordial follicles in the ovary. Continue reading BPES is an autosomal dominant, sex-limited condition with a distinctive eyelid phenotype

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