Premature ovarian insufficiency and infertility

Area of Science:

• Reproductive Endocrinology
• Gynecology

Background:

• Premature ovarian insufficiency (POI) is defined as the loss of ovarian function before age 40.
• POI can arise spontaneously or due to medical treatments (iatrogenic).
• It is a significant factor contributing to infertility in women.

Purpose of the Study:

• To provide a comprehensive overview of diagnosing premature ovarian insufficiency (POI).
• To discuss the management strategies for POI, particularly concerning infertility.
• To highlight fertility preservation options for at-risk individuals.

Main Methods:

• Diagnosis relies on elevated follicle-stimulating hormone (FSH) levels (>25 IU/L) measured twice, at least one month apart.
• A history of oligomenorrhea or amenorrhea lasting 4-6 months is required.
• Secondary causes of amenorrhea must be excluded.

Main Results:

• Around 5% of women may achieve spontaneous pregnancy after a POI diagnosis.
• The majority of women with POI require assisted reproductive technologies, such as donor oocytes or embryos, for pregnancy.
• Alternative family-building options include adoption or remaining childfree.

Conclusions:

• Early consideration of POI is crucial for women with irregular or absent menstruation, even without typical menopausal symptoms.
• Fertility preservation should be discussed with individuals at risk of developing POI.
• Management strategies should address both the diagnosis and the infertility associated with POI.