Premature Ovarian Insufficiency

In women diagnosed with premature ovarian insufficiency (POI), the resting pool of primordial follicles is prematurely exhausted. These women present with absent menses and increased follicle-stimulating hormone (FSH) concentrations along with low estrogens before 40 years of age. The underlying etiology in most cases remains unknown. In a small proportion of cases, POI results from genetic defects, autoimmune disease, or iatrogenic origin (such as surgery, radiotherapy, or chemotherapy). In the absence of contraindications, hormone replacement therapy (HRT) is recommended to mitigate short- and long-term physical and mental symptoms. Little prospectively generated information is available regarding long-term health risks associated with POI. Since fertility is severely compromised in women diagnosed with POI, IVF along with oocyte donation or adoption may be offered. In women at risk for POI, fertility preservation options can be considered.