Premature ovarian insufficiency

Premature ovarian insufficiency (POI) is a clinical syndrome defined as the loss of ovarian activity before the age of 40. POI is a life-changing diagnosis, with profound physical and psychological consequences. Spontaneous POI affects approximately 1% of women under the age of 40. However, the rising incidence of iatrogenic POI is of increasing concern. POI is a heterogeneous, multifactorial disorder, and in the majority of cases the etiology is unknown. The diagnosis of POI is based on the presence of amenorrhea and of an elevated gonadotropin level. Hormone replacement therapy should be used at least until the average age of menopause to alleviate the symptoms of hypoestrogenism and to prevent severe long term consequences especially those of cardiovascular diseases and osteoporosis. The treatment of these women should be coordinated by a multidisciplinary team. Women with POI should be informed that there is a small chance of spontaneous pregnancy. IVF with donor oocytes represents the highest chance for pregnancy in these patients. Further research is needed to identify the population in risk in a timely manner and to find mechanisms that can prolong, recover, or preserve ovarian function