ABSTRACT
Primary ovarian insufficiency (POI) compromises a woman's chance of conceiving with
her own oocytes. Although biomarkers such as serum follicle-stimulating hormone, serum
antimüllerian hormone, and assessment of antral follicle count by transvaginal ultrasound
can give some general idea about ovarian activity and perhaps fertility potential,
no marker will definitively predict if and when childbearing will be possible for
women with POI. No medical therapy has yet been definitively proven to improve ovarian
function and fertility for women with overt POI. Fertility preservation, with cryopreservation
of ovarian tissue, oocytes, or embryos, can be considered for some women with POI
if oocytes are retrievable and current childbearing is not desired, with the caveat
that data regarding long-term safety and efficacy are not available for women with
POI. Options with a high chance of success are oocyte donation, embryo donation, and
adoption. Child-free living may be a reasonable choice for some women. It is beneficial
for women with POI to hear all life-plan and family-building options presented in
a balanced manner.
KEYWORDS
Primary ovarian insufficiency - premature ovarian failure - oocyte donation - embryo
donation - fertility preservation
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Valerie BakerM.D.
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and
Gynecology
Stanford University, 300 Pasteur Drive, HH333, Stanford, CA 94305
eMail: vlbaker@stanford.edu
