Background: Follicular atresia accounts for a >99% reduction in the number of ovarian follicles from intrauterine life to reproductive senescence. Although the mechanism is unclear, the process of accelerated follicular atresia has immense implications for physical, reproductive, and psychologic well-being of the individual. The case of a 17-year-old girl with primary amenorrhea, who was diagnosed with ovarian follicular atresia via an ovarian biopsy is presented, and the available literature on this rare disorder is reviewed. Case: A 17-year-old girl presented to an outpatient department with a history of primary amenorrhea. She also had a history of taking a progestational agent for 5 days 4 months prior to presentation, but this approach failed to work. After various hematologic, endocrine, and radiologic tests, she underwent a diagnostic laparoscopy and histology testing. She was then prescribed a combination of oral contraceptive pills (50 μg ethinyl estradiol in each tablet), vitamin D, and calcium. Results: The patient's postoperative course was uneventful, and she began menstruating 3 months after starting therapy. Conclusions: Ovarian follicular atresia in humans is a complex process that is not yet fully understood. Given the far-reaching physical and psychologic impact of this disorder, current management modalities are aimed at restoring menstrual function and preventing long-term bony and cardiovascular effects of estrogen deprivation. (J GYNECOL SURG 30:294)
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