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Your guide to premature ovarian insufficiency (POI)

Premature ovarian insufficiency (POI) occurs when individuals experience menopausal symptoms before the age of 40. Receiving a diagnosis of POI can be overwhelming, particularly if it affects your fertility.

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In this guide:

Premature ovarian insufficiency can affect your chances of conceiving, so it’s essential to consult your doctor or a fertility clinic if you begin experiencing symptoms.

In this guide, we explore:

- The definition of premature ovarian insufficiency

- The causes and symptoms to watch for

- How different fertility treatments can help

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What is premature ovarian insufficiency?

POI, often referred to as premature menopause, is diagnosed when symptoms of menopause begin before the age of 40. This onset is earlier than the average age of menopause, which typically occurs between 45 and 55.

This condition affects ovarian function and may lead to irregular periods that could stop completely, although ovulation may still occur. Symptoms can persist for years and may include hot flushes, night sweats, muscle pain, anxiety and infertility issues. Fortunately, there are treatments available to help manage these symptoms and support those who wish to build a family.

How is premature ovarian insufficiency diagnosed?

There is no specific test for diagnosing POI. A diagnosis is generally made by considering various factors, including age, symptoms, and the regularity of the menstrual cycle.

A blood test may be conducted to rule out early signs of this condition. This could include checking follicle-stimulating hormone (FSH) levels to assess ovarian function.

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Causes of premature ovarian insufficiency

POI occurs when the ovaries start to function differently, impacting oestrogen levels and ovulation. Here are some of the causes that can trigger the condition.

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Surgical procedures

Surgical procedures that involve the removal of the ovaries, known as oophorectomy, can trigger POI. A hysterectomy, which is the removal of the uterus, can also induce the condition, even if the ovaries are left intact. In some cases, the associated symptoms can appear suddenly and be quite severe.
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Autoimmune conditions

Autoimmune conditions, such as thyroid disorders, lupus, and rheumatoid arthritis, can lead the body to attack ovarian tissue, resulting in POI. Additionally, changes in hormone levels during early menopause can exacerbate symptoms related to these autoimmune conditions.
medical

Cancer treatment

Radiation therapy, particularly when targeting at the pelvic area, can cause POI. Furthermore, chemotherapy can damage ovarian follicles and disrupt hormone production, leading to a decrease in oestrogen levels and the onset of menopausal symptoms.
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Other causes

Other causes include genetics. If a biological family member had POI your risk may be higher. Additionally, lifestyle factors such as smoking, being underweight, and having started menstruation at an early age can also contribute to POI.
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Symptoms of premature ovarian insufficiency

Every individual's symptoms can vary and they can be affected both physically and mentally.

Common symptoms of POI include hot flushes, night sweats, incontinence issues, vaginal dryness or soreness, difficulty sleeping, low mood, anxiety, reduced sex drive, joint and muscle pain, anxiety and difficulty focusing.

If you are experiencing any symptoms or have any concerns, contact your doctor immediately.

How does premature ovarian insufficiency affect fertility?

POI can significantly affect fertility in various ways. When your menstrual cycles become infrequent, conceiving becomes more difficult due to a decrease in the quality and quantity of eggs. During this time, hormonal changes occur until menstruation completely ceases.

However, fertility treatments, such as IVF using donor eggs, can still make conception possible.

Warning signs of infertility
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When to see a fertility specialist

If you are experiencing symptoms of POI, have concerns about a family history of POI, or have been unable to conceive after one year of unprotected sex (or six months if you are over 35), it is important to contact your doctor.

We understand how overwhelming a diagnosis of POI can be. At TFP Fertility, we are here to support you in exploring your next steps and identifying suitable fertility treatments to help you on your fertility journey. Rest assured, our fertility experts will be with you every step of the way.

Treatment

Fertility treatment options

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Hormone therapy

Hormone therapy (HRT) keeps your oestrogen levels topped up to protect against the risk of fragile bones and heart disease. HRT isn't a fertility treatment, but it can help with symptoms of POI.
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In vitro fertilisation (IVF) with an egg donor

If you can no longer make your own eggs, it's still possible to carry and deliver a healthy baby using IVF with a donor egg. The donor eggs can be from someone you know or chosen from our donor bank. After the egg is fertilised with your partner's sperm, the embryo is transferred to your womb.
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Intracytoplasmic sperm injection (ICSI)

ICSI is an additional step during the IVF process that is recommended for patients with male factor infertility or that are using frozen eggs. It involves injecting a single healthy sperm directly into the egg.
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egg freezing

Egg freezing

If you're experiencing POI symptoms, but are not ready to start a family, egg freezing is a good way of preserving your fertility. Freezing your eggs gives you the flexibility to have children when the time is right for you.
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How does surrogacy work

Surrogacy

Surrogacy involves another person carrying and giving birth to a child that you'll become the legal parent of. This is where eggs from another donor are used to create the embryos rather than the surrogate's eggs.
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