Premature ovarian insufficiency

A diagnosis of POI can come as a shock, particularly if it arrives unexpectedly during fertility investigations or routine blood tests. It's natural to have many questions about what this means for your fertility and your health more broadly. Dr Mandana Master provides specialist, compassionate care for women living with premature ovarian insufficiency, helping you understand your diagnosis and explore the options available to you.

Premature ovarian insufficiency – Dr Mandana Master

What is premature ovarian insufficiency?

POI occurs when the ovaries stop functioning normally before the age of 40, leading to reduced production of oestrogen and irregular or absent ovulation. POI is sometimes referred to as premature menopause, although this isn’t always an accurate description – unlike menopause, ovarian function in POI can fluctuate, and you may continue to have occasional periods or even ovulate intermittently.

POI can occur spontaneously, without any identifiable cause, or as a result of genetic conditions, autoimmune disease, or medical treatments such as chemotherapy, radiation therapy, or ovarian surgery.

Common POI symptoms often resemble those associated with natural menopause. These include:

  • Irregular or absent periods
  • Hot flushes
  • Night sweats
  • Vaginal dryness
  • Sleep disturbances 
  • Low mood

How does premature ovarian insufficiency affect fertility?

The primary impact of POI on fertility is through reduced ovarian reserve. Ovarian reserve refers to your remaining egg count, which can also be affected by increasing age, genetics, medical conditions such endometriosis, and lifestyle factors like smoking. 

In addition to a depleted egg count, POI may also affect fertility in other ways.

Irregular or absent ovulation

Many women with POI ovulate infrequently or not at all due to unpredictable hormone fluctuations, making it harder to predict or rely on natural ovulation for conception.

Egg quality

Where ovulation does occur, there is some evidence that egg quality may also be affected in women with POI, with higher rates of DNA damage. This can influence the likelihood of successful fertilisation and also increase the risk of pregnancy complications.

Receiving a diagnosis of POI, particularly at a young age before you have finished building your family, can be emotionally difficult. A consultation with Dr Mandana can provide clarity and guidance around protecting your reproductive potential and options for achieving your family building goals.

How is premature ovarian insufficiency treated?

A POI diagnosis may only be found during routine fertility testing if you have been trying to conceive unsuccessfully for some time. In other cases, it may be identified during investigations for period abnormalities.


Tests for POI include:

Hormone blood tests

Including follicle-stimulating hormone, oestrogen, and anti-Müllerian hormone (AMH).

Pelvic ultrasound

With an antral follicle count to determine the number of egg-containing follicles visible in your ovaries.

You may also undergo additional investigations to gain a better understanding of your health in the context of POI, as this condition is linked to a number of chronic conditions and long-term health risks such as autoimmune disorders and osteoporosis.


Treatment for POI is primarily focused on managing symptoms, protecting long-term health, and supporting your fertility goals. Potential approaches include:

Hormone replacement therapy (HRT)

To manage symptoms of low oestrogen and protect bone and cardiovascular health.

IVF with donor eggs

Often a highly effective option for women with significantly diminished ovarian reserve, allowing pregnancy to be achieved using eggs from a donor.

For women diagnosed with POI in its early days, or who are at risk of the condition due to upcoming medical treatment or with a known family history of POI, freezing eggs or ovarian tissue as early as possible may help preserve future options.

Dr Mandana understands that a diagnosis of POI raises both medical and deeply personal questions, and will support you in exploring every avenue available to you at a pace that feels right for your circumstances.

Frequently Asked Questions

Yes, natural pregnancy is unlikely but still possible for some women with POI, as ovarian function can fluctuate and intermittent ovulation may occur even after diagnosis. If you have POI and do not wish to fall pregnant, it is important to keep using contraception until you have not had a period for 12 consecutive months, which then marks the start of menopause.

POI can occur spontaneously without any identifiable cause, or as a result of genetic conditions, autoimmune disease, or medical treatments such as chemotherapy, radiation, or ovarian surgery. In many cases, despite thorough investigation, no clear cause is found.

This depends on your individual ovarian reserve and hormonal profile. For some women with POI, particularly when there is still some egg supply remaining, IVF using their own eggs may be possible, although success rates are generally lower than for women without POI. For others with very limited ovarian reserve, donor eggs may offer a more effective path to pregnancy. A consultation with Dr Mandana is the best way to understand which options are realistic for you. 

Ready to take the first step?

Ready to take the first step?

If you need specialist advice and care for achieving your family building goals, you’ve come to the right place. Get in touch with Dr Mandana Master at Embrace Fertility today.

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