Premature Ovarian Failure: ESHRE Guidelines and Current Studies

Abstract

The loss of ovarian function before the age of 40 years is called premature ovarian failure (POI) and has a prevalence of 1–2%. In order to be able to diagnose POI, amenorrhea or oligomenorrhea must have been present for 4 months and two FSH measurements >25 IU/ml at an interval of 4 weeks. Genetic disorders, autoimmune diseases and gonadotoxic therapies may be the cause, but probably the largest proportion seems to be idiopathic. In a manifest POI, the spontaneous pregnancy rate is 1.5 to a maximum of 5%, usually an egg donation is inevitable. A consultation on fertility protection prior to a gonadotoxic therapy should be offered at a specialized center. Women with POI have a reduced life expectancy due to an increased risk of cardiovascular disease. Osteoporosis also occurs frequently, as well as other estrogen deficiency symptoms. Hormone replacement therapy is indicated until the onset of normal menopause age.