Premature Ovarian Insufficiency: Aetiology and Long-Term Consequences

Abstract

Premature ovarian insufficiency (POI) is characterised by premature cessation of ovulation/
 menstruation for 4-6 months along with raised serum gonadotropin levels especially follicle 
stimulating hormone (FSH) (>40 IU/L) on two or more occasions >4 weeks apart. POI is a 
heterogeneous disorder resulting from various autoimmune, iatrogenic and metabolic factors, 
chromosomal or genetic mutations and infections. Premature loss of ovarian function in women 
with POI is associated with long-term psychosocial sequelae, infertility and major health com
plications. It is also associated with age-specific increase in mortality due to cardio-vascular 
diseases. Its occurrence has increased in recent years as more and more women now-a-days at
tain motherhood late, also there is increase in incidence of gynaecological malignancies and its 
successful management leading to increased risk of POI. This manuscript aims to highlight the 
recent advances in pathogenesis and management of POI. Literature regarding premature ovar
ian insufficiency, its incidence, pathogenesis, management and recent advances was searched 
from various English language journals, WHO, ACOG data, published peer-reviewed articles 
on PubMed, Medline, Embase and Google Scholar upto 2017.