Vol 92, No 7 (2021)
Review paper
Published online: 2021-05-07

open access

Page views 1956
Article views/downloads 1980
Get Citation

Connect on Social Media

Connect on Social Media

Fresh insight into premature ovarian insufficiency

Paula Karska1, Aleksandra Matonog1, Paulina Sieradzka1, Karolina Kowalczyk1, Pawel Madej1
Pubmed: 34105755
Ginekol Pol 2021;92(7):518-524.


Premature ovarian insufficiency (POI) is one of the vital reasons of anovulatory infertility among women under 40 years old. However, because of the unacknowledged causative factor in most cases, it still remains a huge challenge in gynecology. Recently, the most promising opportunities in diagnosing are connected with the use of some serum biomarkers, such as interleukin-17 (IL-17), Frizzled-5 protein, Soggy-1 protein and other cytokines. Additionally, environmental toxicants such as chemicals and heavy metals might be relevant in the near future when investigating the causes of premature ovarian insufficiency. One of the main aims of the therapy is to focus on maintaining fertility among women with POI, since it is essential for patients considering their young age. Among the newest approaches listed there are different types of stem cells, oocytes donation and in-vitro activation, all of which are recently gaining in importance.

Article available in PDF format

View PDF Download PDF file


  1. Rudnicka E, Kruszewska J, Klicka K, et al. Premature ovarian insufficiency - aetiopathology, epidemiology, and diagnostic evaluation. Prz Menopauzalny. 2018; 17(3): 105–108.
  2. Wu X, Cai H, Kallianpur A, et al. Impact of premature ovarian failure on mortality and morbidity among Chinese women. PLoS One. 2014; 9(3): e89597.
  3. Lagergren K, Hammar M, Nedstrand E, et al. The prevalence of primary ovarian insufficiency in Sweden; a national register study. BMC Womens Health. 2018; 18(1): 175.
  4. Gruber N, Kugler S, de Vries L, et al. Primary ovarian insufficiency nationwide incidence rate and etiology among Israeli adolescents. J Adolesc Health. 2020; 66(5): 603–609.
  5. Webber L, Davies M, Anderson R, et al. European Society for Human Reproduction and Embryology (ESHRE) Guideline Group on POI. ESHRE Guideline: management of women with premature ovarian insufficiency. Hum Reprod. 2016; 31(5): 926–937.
  6. França MM, Mendonca BB. Genetics of primary ovarian insufficiency in the next-generation sequencing era. J Endocr Soc. 2020; 4(2): bvz037.
  7. Qin Y, Jiao X, Simpson JL, et al. Genetics of primary ovarian insufficiency: new developments and opportunities. Hum Reprod Update. 2015; 21(6): 787–808.
  8. Hoyos LR, Thakur M. Fragile X premutation in women: recognizing the health challenges beyond primary ovarian insufficiency. J Assist Reprod Genet. 2017; 34(3): 315–323.
  9. He WB, Tan C, Zhang YX, et al. Homozygous variants in cause premature ovarian insufficiency. J Med Genet. 2021; 58(3): 168–172.
  10. Alavi A, Darki F, Bidgoli MM, et al. Mutation in ALOX12B likely cause of POI and also ichthyosis in a large Iranian pedigree. Mol Genet Genomics. 2020; 295(4): 1039–1053.
  11. Renault L, Patiño LC, Magnin F, et al. BMPR1A and BMPR1B missense mutations cause primary ovarian insufficiency. J Clin Endocrinol Metab. 2020; 105(4): dgz226.
  12. Yang Y, Guo T, Liu R, et al. FANCL gene mutations in premature ovarian insufficiency. Hum Mutat. 2020; 41(5): 1033–1041.
  13. Domniz N, Meirow D. Premature ovarian insufficiency and autoimmune diseases. Best Pract Res Clin Obstet Gynaecol. 2019; 60: 42–55.
  14. Welt CK, Shapiro CL. Ovarian failure due to anticancer drugs and radiation. UpToDate. https://www.uptodate.com/contents/ovarian-failure-due-to-anticancer-drugs-and-radiation?search=premature ovarian insufficiency&topicRef=7435&source=see_link#H465437487 (2020-05-21).
  15. Cosgrove CM, Salani R. Ovarian effects of radiation and cytotoxic chemotherapy damage. Best Pract Res Clin Obstet Gynaecol. 2019; 55: 37–48.
  16. Monteiro Cd, Xavier EB, Caetano JP, et al. A critical analysis of the impact of endocrine disruptors as a possible etiology of primary ovarian insufficiency. JBRA Assist Reprod. 2020; 24(3): 324–331.
  17. Łukaszuk K, Kozioł K, Jakiel G, et al. Diagnostyka i leczenie niepłodności — rekomendacje Polskiego Towarzystwa Medycyny Rozrodu i Embriologii (PTMRiE) oraz Polskiego Towarzystwa Ginekologów i Położników (PTGP). Ginekol i Perinatol Prakt. 2018; 3(3): 112–140.
  18. Fraison E, Crawford G, Casper G, et al. Pregnancy following diagnosis of premature ovarian insufficiency: a systematic review. Reprod Biomed Online. 2019; 39(3): 467–476.
  19. Michala L, Stefanaki K, Loutradis D. Premature ovarian insufficiency in adolescence: a chance for early diagnosis? Hormones (Athens). 2020; 19(3): 277–283.
  20. Liu J, Huang X, Cao X, et al. Serum biomarker analysis in patients with premature ovarian insufficiency. Cytokine. 2020; 126: 154876.
  21. Hamoda H. British Menopause Society and Women’s Health Concern. The British Menopause Society and Women's Health Concern recommendations on the management of women with premature ovarian insufficiency. Post Reprod Health. 2017; 23(1): 22–35.
  22. Committee Opinion No. 698 Summary: Hormone Therapy in Primary Ovarian Insufficiency. Obstet Gynecol. 2017; 129(5): 963–964.
  23. Webber L, Anderson RA, Davies M, et al. HRT for women with premature ovarian insufficiency: a comprehensive review. Hum Reprod Open. 2017; 2017(2): hox007.
  24. Sheikhansari G, Aghebati-Maleki L, Nouri M, et al. Current approaches for the treatment of premature ovarian failure with stem cell therapy. Biomed Pharmacother. 2018; 102: 254–262.
  25. Bidet M, Bachelot A, Bissauge E, et al. Resumption of ovarian function and pregnancies in 358 patients with premature ovarian failure. J Clin Endocrinol Metab. 2011; 96(12): 3864–3872.
  26. Guideline of the European Society of Human Reproduction and Embryology. Management of women with premature ovarian insufficiency. POI Guideline Development Group. 2015: 54–62.
  27. Kawamura K, Kawamura N, Hsueh AJW. Activation of dormant follicles: a new treatment for premature ovarian failure? Curr Opin Obstet Gynecol. 2016; 28(3): 217–222.
  28. Suzuki N, Yoshioka N, Takae S, et al. Successful fertility preservation following ovarian tissue vitrification in patients with primary ovarian insufficiency. Hum Reprod. 2015; 30(3): 608–615.
  29. Chan JL, Wang ET. Oncofertility for women with gynecologic malignancies. Gynecol Oncol. 2017; 144(3): 631–636.
  30. Takai Y. Recent advances in oncofertility care worldwide and in Japan. Reprod Med Biol. 2018; 17(4): 356–368.