Abstract
Primary ovarian insufficiency (POI) is an uncommon yet devastating occurrence that results from a premature depletion of the ovarian pool of primordial follicles. Our understanding of both putative and plausible mechanisms underlying POI, previously considered to be largely “idiopathic”, has been furthered over the past several years, largely due to advances in the field of genetics and through expansion of translational models for experimental research. In this review, our goal is to familiarize the multidisciplinary readers of the F1000 platform with the strides made in the field of reproductive medicine that hold both preventative and therapeutic implications for those women who are at risk for or who have POI.
Highlights
Despite the resounding progress that the field of reproductive endocrinology has witnessed over the past three decades, our understanding of the myriad of mechanisms causative to the entity of primary ovarian insufficiency (POI) remains lagging
We recently reviewed the clinical presentation and diagnosis of POI1
The diagnosis of POI is dependent on evidence of hypergonadotropic hypogonadism, namely elevated serum levels of the pituitary gonadotropin follicle-stimulating hormone (FSH) with low serum levels of estradiol (E2) in a patient who has irregular or absent menses and is younger than 40 years
Summary
Despite the resounding progress that the field of reproductive endocrinology has witnessed over the past three decades, our understanding of the myriad of mechanisms causative to the entity of primary ovarian insufficiency (POI) remains lagging. Consequences of POI range from psychological devastation relating to the diagnosis to symptom burden, of which loss of fertility dominates the spectrum, to the long-term consequences of premature loss of ovarian function which include an increased lifetime risk for skeletal fragility and cardiovascular and neurocognitive disorders. The treatment modalities available to patients with POI were limited to the use of hormone therapy to mitigate symptom burden and minimize long-term risks of estrogen deprivation as well as the use of donor eggs as the only viable option for biological parenting. We recently reviewed the clinical presentation and diagnosis of POI1. The purpose of the present review is to familiarize readers with the recent advances that have furthered our understanding of POI and which, in the foreseeable future, may even offer women with POI hope for biological parenting in every sense of the expression
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