What laboratory finding confirms the diagnosis of primary ovarian failure?

The diagnosis of primary ovarian failure, also known as primary ovarian insufficiency, is characterized by the failure of the ovaries to produce adequate amounts of hormones, leading to a disruption of the normal menstrual cycle and fertility. The correct laboratory finding that confirms this diagnosis is the elevation of follicle-stimulating hormone (FSH) levels in the menopausal range.

In primary ovarian failure, the ovaries are unable to respond to the gonadotropins released by the pituitary gland, which includes both FSH and luteinizing hormone (LH). When the ovaries fail to produce adequate estrogen, the negative feedback mechanism on the pituitary gland is diminished, causing an increase in FSH levels. Elevated FSH, particularly in the menopausal range (usually greater than 30 mIU/mL), indicates that the body is attempting to stimulate the ovaries, but they are not functioning properly.

While elevated LH levels can also be present, it is the elevation of FSH that is the more definitive marker for diagnosing primary ovarian failure. Low estrogen levels can be a consequence of this condition but are not diagnostic on their own. An ultrasound showing ovarian cysts may suggest other conditions but is not indicative of primary ovarian failure as it does not directly measure