PhD defence C. (Charissa) Zwol-Janssens

Below is a brief summary of the dissertation:

As women age, their ovarian function naturally declines until menopause begins, typically around age 51. However, when this happens before the age of 40, it is known as Premature Ovarian Insufficiency (POI), a condition that profoundly impacts a woman's life. This PhD thesis focuses on two critical missions: improving how we predict ovarian aging and revolutionizing long-term care for women with POI. 
Can we foresee how the ovaries age? Our research shows that a woman’s genetic profile can successfully predict how she will respond to IVF treatments, opening doors for personalized fertility care. However, predicting whether ovarian function will return after chemotherapy remains a challenge. While higher levels of the Anti-Mullerian Hormone (AMH) indicate a better chance of recovery, the lack of an international measurement standard means AMH testing is not yet reliable enough to safely guide cancer treatment adjustments. 
The second part of the thesis evaluates a specialized, patient-centered 'Value-Based Healthcare' program designed for women with POI. The findings are a wake-up call: despite receiving hormone replacement therapy, over half of these patients still battle depressive symptoms, and many suffer from high blood pressure or low bone density. Furthermore, using CT scans, we discovered that a shorter lifelong exposure to estrogen directly links to fragile bones and accelerated cardiometabolic aging.