Premature Ovarian Insufficiency and Diminished Ovarian Reserve: From Diagnosis to Current Management and Treatment

Premature ovarian insufficiency (POI) and diminished ovarian reserve (DOR) are two related conditions characterized by a reduced ovarian reserve. Their etiologies are multifactorial, encompassing iatrogenic causes such as chemotherapy, pelvic surgery, or radiotherapy, as well as non-iatrogenic factors including genetic and chromosomal abnormalities, environmental exposures, autoimmune mechanisms and idiopathic sources. Early recognition of these conditions is essential, as timely and appropriate management can significantly impact both reproductive potential and long-term health. In women with POI, hormone replacement therapy is required to prevent the detrimental effects of estrogen deficiency on wellbeing and overall health, while in women with DOR, management focuses on counseling, fertility preservation when pregnancy is not an immediate goal, and strategies to optimize assisted reproductive outcomes when conception is desired. In addition, emerging research into ovarian rejuvenation offers promising new avenues for future therapeutic approaches. This review summarizes current knowledge on the pathophysiology, diagnosis, and management of POI and DOR, while highlighting innovative developments in reproductive medicine.