Materiały źródłowe

• #1 Premature ovarian insufficiency – aetiopathology, epidemiology, and diagnostic evaluation

  https://www.termedia.pl/Premature-ovarian-insufficiency-aetiopathology-epidemiology-and-diagnostic-evaluation,4,33841,1,1.html

  Premature ovarian insufficiency (POI) is a disorder characterised by ovarian dysfunction leading to hypoestrogenism and loss of residual follicles in the gonads associated with oligo- or amenorrhoea and subfertility or infertility. Among women with primary amenorrhoea, the frequency of POI is 10-28% and in those with secondary amenorrhoea 4-18%. The risk of premature ovarian insufficiency (POI) before the age of 40 years is 1%. The prevalence of menopause varies according to age, and it is 1 : 10,000 at the age of 18-25 years, 1 : 1000 in women aged 25-30 years, and 1 : 100 in the age range 35-40 years. POI is related with familiar occurrence in about 15% of cases, which suggests a genetic aetiological background. Epidemiological studies have shown differences in the occurrence of POI depending on ethnicity, and it is highest in Caucasian, African American, and Hispanic women.

• #2 Factors leading to primary ovarian insufficiency: a literature overview – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/02-2021/factors-leading-to-primary-ovarian-insufficiency-a-literature-overview/

  Premature ovarian insufficiency (POI) is a disease characterized by oligomenorrhea, hypoestrogenism and elevated gonadotropin levels that occurs in women younger than 40 years of age. There are several possible causes of POI, including chromosomal and genetic diseases, and autoimmune, infectious or iatrogenic events. POI can be classified as primary (spontaneous) or secondary (iatrogenic). […] It has been suggested that POI may affect 1% of women under 40. […] Depending on the cause, POI can be classified as primary (spontaneous) or secondary (iatrogenic). […] Although the disease is not particularly frequent in the general population, it is crucial to make an early diagnosis, as the consequences of primary POI, when untreated, differ from those of other disorders characterized by menstrual irregularity, such as polycystic ovarian syndrome or hypothalamic amenorrhea.

• #3 Primary ovarian insufficiency in cancer survivors: Keys to optimal management | Anales de Pediatría

  https://www.analesdepediatria.org/en-primary-ovarian-insufficiency-in-cancer-articulo-S2341287923002612

  Primary ovarian insufficiency (POI) carries significant morbidity, causing infertility, sexual disfunction, decreased bone density, cardiovascular risk, emotional distress and early mortality. […] The prevalence of POI in the general population is approximately 1.8%. It is greater in patients with cancer or diseases requiring chemotherapy and/or radiation therapy. In the current literature, some studies have reported that the incidence of POI is 3.5 times greater in girls and female adolescents who are cancer survivors compared to their peers. […] Close monitoring of ovarian function in girls and women exposed to gonadotoxic treatments is important, as it offers the opportunity of pursuing fertility preservation options, especially in cases in which it was not possible to do so before initiation of treatment.

• #4 Ovarian Insufficiency: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/271046-overview

  POI/POF occurs in approximately 1% of women. The estimated incidence in the United States is 1 case per 1000 women by age 30, 1 case per 250 women by age 35 and 1 case per 100 women by age 40. Approximately 10-28% of women with primary amenorrhea and 4-18% with secondary amenorrhea have POI/POF. […] The incidence of spontaneous POF/POI appears to be similar among ethnic groups; however, one study showed that it may be more common in Hispanic and African American women and less common in Chinese and Japanese women compared with White women. […] Ovarian insufficiency occurs only in women. By definition, POI/POF is a condition of women younger than 40 years.

• #5 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Primary ovarian insufficiency (POI) is thought to arise from either follicular dysfunction or follicular depletion. However, the exact mechanisms in which POI develops remain unknown. Approximately 90% of all diagnosed cases of spontaneous POI do not have a determined underlying etiology. […] The proportion of women that primary ovarian insufficiency (POI) impacts do not mirror the devastating effects that this disease spectrum causes. POI affects approximately 1 to 2% of women under the age of 40 and even fewer women under the age of 30 (approximately 0.1%). This contrasts greatly with menopause, where the average age is 50 +/- 4 years. Only 4% of women under the age of 45 years old will undergo menopause early. […] The course of POI is variable and unpredictable. As such, approximately 4-10% of women with POI may conceive naturally and approximately 20% will have successful ovulation induction. However, due to the variability of the disease, the overall success of pregnancy and live birth only reaches 25% after cryopreservation and implantation of embryos. A women’s probability of pregnancy increases to approximately 40% in the setting of oocyte donation after one cycle of IVF and climbs to 70-80% with four cycles of IVF.

• #6 The prevalence of primary ovarian insufficiency in Sweden; a national register study | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-018-0665-2

  The current estimates of the prevalence of primary ovarian insufficiency (POI) are very variable, but are in most studies believed to be around 1%. […] We therefore aimed to assess the prevalence of primary ovarian insufficiency in Sweden. […] Out of the 1,036,918 women, 19,253 (1.9%) had POI. The prevalence of spontaneous POI was 1.7% and the prevalence of iatrogenic POI was 0.2%. […] The total prevalence of POI was 1.9%, 95% CI: 1.72.1, indicating a higher prevalence than often previously reported. […] In this national cohort study of 1,036,918 women born between 1973 and 1993 we found a total prevalence of POI of 1.9%. […] The vast majority of cases were identified from the Prescribed Drug Register using HRT rather than from the Patient Register. […] In conclusion, the present study shows a prevalence of 1.9%, indicating a higher prevalence of POI than previously often reported. […] In conclusion, POI is prevalent, apparently more prevalent than often previously reported. Since women with POI face serious health risks both mental and physical, they need thorough medical information, surveillance and hormonal treatment.

• #7

  https://journals.lww.com/abhs/fulltext/2024/03030/overview_of_prevalence,_etiology,_clinical.2.aspx

  Primary ovarian insufficiency (POI) is the development of primary hypogonadism before the age of 40 years in women with normal karyotypes. The incidence of spontaneous POI is approximately 1 in 250 by 35 years of age and 1 in 100 by 40 years of age. […] Although Coulam et al. reported that the prevalence of POI was 1% in 1986, a recent 2019 meta-analysis involving 31 articles suggested that the prevalence of POI and early menopause was approximately 3.7% and 12.2%, respectively. […] A 2021 population-based study conducted in Tehran included 6521 eligible postmenarcheal participants of the Tehran Lipid and Glucose Study. The menopausal group was filtered by age; 3.5% experienced POI, and 24.6% had entered early menopause. […] Another study conducted in 2018 included 1,036,918 Swedish women born between 1973 and 1993. The estimated prevalence of POI was 1.9%, based on data collected from the Swedish patient registry.

• #8 Evidence-based guideline: Premature Ovarian Insufficiency (2024) | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/evidence-based-guideline-premature-ovarian-insufficiency–2024/

  The reported prevalence of non-iatrogenic POI varies from approximately 1% in older studies to 3.5% in recent publications. Population characteristics such as ethnicity may affect the prevalence of noniatrogenic POI. […] New data indicate a higher prevalence of POI, 3.5%, than was previously thought. […] The guideline provides health care professionals with clear advice on best practice in POI care, based on the best evidence currently available.

• #9 The prevalence of primary ovarian insufficiency in Sweden; a national register study | BMC Women’s Health | Full Text

  https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-018-0665-2

  The current estimates of the prevalence of primary ovarian insufficiency (POI) are very variable, but are in most studies believed to be around 1%. […] We therefore aimed to assess the prevalence of primary ovarian insufficiency in Sweden. […] Out of the 1,036,918 women, 19,253 (1.9%) had POI. The prevalence of spontaneous POI was 1.7% and the prevalence of iatrogenic POI was 0.2%. […] The total prevalence of POI was 1.9%, 95% CI: 1.72.1, indicating a higher prevalence than often previously reported. […] In this national cohort study of 1,036,918 women born between 1973 and 1993 we found a total prevalence of POI of 1.9%. […] The vast majority of cases were identified from the Prescribed Drug Register using HRT rather than from the Patient Register. […] In conclusion, the present study shows a prevalence of 1.9%, indicating a higher prevalence of POI than previously often reported. […] In conclusion, POI is prevalent, apparently more prevalent than often previously reported. Since women with POI face serious health risks both mental and physical, they need thorough medical information, surveillance and hormonal treatment.

• #10

  https://journals.lww.com/abhs/fulltext/2024/03030/overview_of_prevalence,_etiology,_clinical.2.aspx

  Approximately 1%2% of women develop hypergonadotropic hypogonadism before reaching the age of 40 years. The prevalence of POI is expected to drop by a factor of 10 every decade before the age of 40 years; therefore, 1% of women under the age of 40 years and 0.1% of women under 30 years of age are affected. […] Diagnosis and subsequent management can be delayed owing to variations in clinical manifestations and, more importantly, the lack of public awareness regarding this condition. […] Given the significant amount of research on this subject, this review aims to cover the most up-to-date scientific data regarding POI, including its etiology, long-term effects, and management options, to provide accurate and precise information for health-care providers and the general population. […] The diagnosis is completed using transvaginal ultrasound to evaluate the ovarian reserve, which shows low antral follicle counts and small ovarian volumes with a thin endometrial echo.

• #11 Clinical manifestations and diagnosis of primary ovarian insufficiency (premature ovarian failure) – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-primary-ovarian-insufficiency-premature-ovarian-failure/print

  Primary ovarian insufficiency (POI) is defined as the development of hypergonadotropic hypogonadism before the age of 40 years. The age-specific incidence of POI is approximately 1 in 250 by age 35 years and 1 in 100 by age 40 years. Menopause before age 40 years is considered to be abnormal and is referred to as primary ovarian insufficiency (POI). POI is a spectrum disorder and is a continuum of impaired ovarian function. Overt POI refers to the presence of irregular menses, elevated serum gonadotropins, and reduced fertility.

• #12 Clinical manifestations and diagnosis of primary ovarian insufficiency (premature ovarian failure) – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-primary-ovarian-insufficiency-premature-ovarian-failure

  The age-specific incidence of POI is approximately 1 in 250 by age 35 years and 1 in 100 by age 40 years. […] Menopause before age 40 years is considered to be abnormal and is referred to as primary ovarian insufficiency (POI). […] POI is a spectrum disorder and is a continuum of impaired ovarian function.

• #13 Premature ovarian failure | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-1-9

  Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea). It is a heterogeneous disorder affecting approximately 1% of women 40 years, 1:10,000 women by age 20 and 1:1,000 women by age 30. […] POF affects approximately: one in 10,000 women by age 20; one in 1,000 women by age 30; one in 100 women by age 40. The familial form of POF is rare, representing 4 to 31% of all cases of POF. […] The early diagnosis of familial POF will provide the opportunity to predict the likelihood of early menopause, and allow other reproductive choices to be made, such as freezing embryos or having children earlier. As POF has cumulative negative effects over time, it is important for clinicians to make a timely diagnosis and begin appropriate strategies for symptom management, emotional support, and risk reduction.

• #14 Premature Ovarian Insufficiency | Doctor

  https://patient.info/doctor/premature-ovarian-insufficiency-pro

  At least 1% of women under the age of 40 are affected. […] The term premature ovarian insufficiency encompasses both spontaneous POI and POI which occurs as a result of iatrogenic interventions. […] 0.1% of women aged under 30 and 0.01% of women aged under 20 are affected.

• #15 Primary ovarian insufficiency – Wikipedia

  https://en.wikipedia.org/wiki/Primary_ovarian_insufficiency

  The prevalence increases with age and is approximately 1 in 10,000 women under age 20, 1 in 1,000 women under age 30, and one percent by age of 40. It occurs in 3.7% of women worldwide and 1% of women in the United States. In the United States, the incidence is 1% in White women, 1.4% in Black and Hispanic women, with lower rates seen in Chinese and Japanese women, at 0.5% and 0.1% respectively. […] POI affects approximately 1 in 10,000 women under age 20, 1 in 1,000 women under age 30, and 1 in 100 of those under age 40.

• #16 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Primary ovarian insufficiency (POI) is thought to arise from either follicular dysfunction or follicular depletion. However, the exact mechanisms in which POI develops remain unknown. Approximately 90% of all diagnosed cases of spontaneous POI do not have a determined underlying etiology. […] The proportion of women that primary ovarian insufficiency (POI) impacts do not mirror the devastating effects that this disease spectrum causes. POI affects approximately 1 to 2% of women under the age of 40 and even fewer women under the age of 30 (approximately 0.1%). This contrasts greatly with menopause, where the average age is 50 +/- 4 years. Only 4% of women under the age of 45 years old will undergo menopause early. […] The course of POI is variable and unpredictable. As such, approximately 4-10% of women with POI may conceive naturally and approximately 20% will have successful ovulation induction. However, due to the variability of the disease, the overall success of pregnancy and live birth only reaches 25% after cryopreservation and implantation of embryos. A women’s probability of pregnancy increases to approximately 40% in the setting of oocyte donation after one cycle of IVF and climbs to 70-80% with four cycles of IVF.

• #17 Primary ovarian insufficiency – Wikipedia

  https://en.wikipedia.org/wiki/Primary_ovarian_insufficiency

  The prevalence increases with age and is approximately 1 in 10,000 women under age 20, 1 in 1,000 women under age 30, and one percent by age of 40. It occurs in 3.7% of women worldwide and 1% of women in the United States. In the United States, the incidence is 1% in White women, 1.4% in Black and Hispanic women, with lower rates seen in Chinese and Japanese women, at 0.5% and 0.1% respectively. […] POI affects approximately 1 in 10,000 women under age 20, 1 in 1,000 women under age 30, and 1 in 100 of those under age 40.

• #18

  https://step1.medbullets.com/reproductive/116035/primary-ovarian-insufficiency

  1 in 250 by age 35 years. […] 1 in 100 by age 40 years.

• #19 Population-based estimates of the prevalence of FMR1 expansion mutations in women with early menopause and primary ovarian insufficiency | Genetics in Medicine

  https://www.nature.com/articles/gim201364

  Primary ovarian insufficiency before the age of 40 years affects 1% of the female population and is characterized by permanent cessation of menstruation. […] The prevalence of FMR1 expansion mutations in early menopause (between the ages of 40 and 45 years) has not been published. […] The prevalence of the premutation was 2.0% in primary ovarian insufficiency, 0.7% in early menopause, and 0.4% in controls, corresponding to odds ratios of 5.4 for primary ovarian insufficiency and 2.0 for early menopause. […] FMR1 premutations are not as prevalent in women with ovarian insufficiency as previous estimates have suggested, but they still represent a substantial cause of primary ovarian insufficiency and early menopause. […] Several studies have investigated the prevalence of the FMR1 premutation in series of women ascertained via POI.

• #20 Primary Ovarian Insufficiency | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816949/2.1/Primary_Ovarian_Insufficiency

  Primary ovarian insufficiency (POI) is used to describe a spectrum of conditions including hypergonadotropic hypogonadism, premature ovarian failure (POF), and ovarian dysgenesis in women 40 years of age. […] The age-specific incidence is approximately 1/1,000 by age 30 years, 1/250 by age 35 years, and 1/100 by age 40 years. […] POI affects approximately 1% of the population in the United States.

• #21 Primary Ovarian Insufficiency | Concise Medical Knowledge

  https://www.lecturio.com/concepts/primary-ovarian-insufficiency/

  Primary ovarian insufficiency is primarily idiopathic. […] 90% of cases are idiopathic. […] 10%-15% of women have an affected first-degree relative. […] Primary ovarian insufficiency is the depletion or dysfunction of ovarian follicles resulting in cessation of ovulation prior to age 40. […] The disorder is accompanied by high levels of FSH prior to age 40. […] Incidence: 1:100 women by age 40, 1:250 women by age 35. […] Once the diagnosis of POI is made, screening for autoimmune adrenal antibodies and a karyotype should be obtained. […] Management includes hormone replacement therapy, addressing fertility concerns as desired, and psychological support. […] Primary ovarian insufficiency can be caused by chromosomal and genetic defects, an autoimmune process, or ovarian toxins; however, in the vast majority of cases, a clear cause is never identified.

• #22 Premature ovarian insufficiency – aetiopathology, epidemiology, and diagnostic evaluation

  https://www.termedia.pl/Premature-ovarian-insufficiency-aetiopathology-epidemiology-and-diagnostic-evaluation,4,33841,1,1.html

  Premature ovarian insufficiency (POI) is a disorder characterised by ovarian dysfunction leading to hypoestrogenism and loss of residual follicles in the gonads associated with oligo- or amenorrhoea and subfertility or infertility. Among women with primary amenorrhoea, the frequency of POI is 10-28% and in those with secondary amenorrhoea 4-18%. The risk of premature ovarian insufficiency (POI) before the age of 40 years is 1%. The prevalence of menopause varies according to age, and it is 1 : 10,000 at the age of 18-25 years, 1 : 1000 in women aged 25-30 years, and 1 : 100 in the age range 35-40 years. POI is related with familiar occurrence in about 15% of cases, which suggests a genetic aetiological background. Epidemiological studies have shown differences in the occurrence of POI depending on ethnicity, and it is highest in Caucasian, African American, and Hispanic women.

• #23 Primary ovarian insufficiency – Wikipedia

  https://en.wikipedia.org/wiki/Primary_ovarian_insufficiency

  The prevalence increases with age and is approximately 1 in 10,000 women under age 20, 1 in 1,000 women under age 30, and one percent by age of 40. It occurs in 3.7% of women worldwide and 1% of women in the United States. In the United States, the incidence is 1% in White women, 1.4% in Black and Hispanic women, with lower rates seen in Chinese and Japanese women, at 0.5% and 0.1% respectively. […] POI affects approximately 1 in 10,000 women under age 20, 1 in 1,000 women under age 30, and 1 in 100 of those under age 40.

• #24 Primary Ovarian Insufficiency: Time to Diagnosis and a Review of Current Literature

  https://www.imrpress.com/journal/CEOG/49/6/10.31083/j.ceog4906129/htm

  Primary ovarian insufficiency (POI) is a condition defined by the loss of normal ovarian function before the age of 40. POI affects 1% of women overall, but prevalence varies greatly by age. POI affects 1 in 10,000 women between ages 18–25, 1 in 1000 women between ages 25–30, and 1 in 100 women between ages 35–40, making the latter the most common age group for onset of this condition. Epidemiological studies have also demonstrated variation in the prevalence of POI among women in different ethnic and socioeconomic groups. In one analysis, African American, Hispanic, and Caucasian women had a relatively higher occurrence of POI (1.4%, 1.4%, and 1%, respectively), followed by Chinese (0.5%) and Japanese (0.1%) women. This study also assessed variables such as income and level of education, and determined that low socioeconomic status was associated with a higher prevalence of POI.

• #25 Ovarian Insufficiency: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/271046-overview

  POI/POF occurs in approximately 1% of women. The estimated incidence in the United States is 1 case per 1000 women by age 30, 1 case per 250 women by age 35 and 1 case per 100 women by age 40. Approximately 10-28% of women with primary amenorrhea and 4-18% with secondary amenorrhea have POI/POF. […] The incidence of spontaneous POF/POI appears to be similar among ethnic groups; however, one study showed that it may be more common in Hispanic and African American women and less common in Chinese and Japanese women compared with White women. […] Ovarian insufficiency occurs only in women. By definition, POI/POF is a condition of women younger than 40 years.

• #26 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Primary ovarian insufficiency (POI) is thought to arise from either follicular dysfunction or follicular depletion. However, the exact mechanisms in which POI develops remain unknown. Approximately 90% of all diagnosed cases of spontaneous POI do not have a determined underlying etiology. […] The proportion of women that primary ovarian insufficiency (POI) impacts do not mirror the devastating effects that this disease spectrum causes. POI affects approximately 1 to 2% of women under the age of 40 and even fewer women under the age of 30 (approximately 0.1%). This contrasts greatly with menopause, where the average age is 50 +/- 4 years. Only 4% of women under the age of 45 years old will undergo menopause early. […] The course of POI is variable and unpredictable. As such, approximately 4-10% of women with POI may conceive naturally and approximately 20% will have successful ovulation induction. However, due to the variability of the disease, the overall success of pregnancy and live birth only reaches 25% after cryopreservation and implantation of embryos. A women’s probability of pregnancy increases to approximately 40% in the setting of oocyte donation after one cycle of IVF and climbs to 70-80% with four cycles of IVF.

• #27 Primary Ovarian Insufficiency | Concise Medical Knowledge

  https://www.lecturio.com/concepts/primary-ovarian-insufficiency/

  Primary ovarian insufficiency is primarily idiopathic. […] 90% of cases are idiopathic. […] 10%-15% of women have an affected first-degree relative. […] Primary ovarian insufficiency is the depletion or dysfunction of ovarian follicles resulting in cessation of ovulation prior to age 40. […] The disorder is accompanied by high levels of FSH prior to age 40. […] Incidence: 1:100 women by age 40, 1:250 women by age 35. […] Once the diagnosis of POI is made, screening for autoimmune adrenal antibodies and a karyotype should be obtained. […] Management includes hormone replacement therapy, addressing fertility concerns as desired, and psychological support. […] Primary ovarian insufficiency can be caused by chromosomal and genetic defects, an autoimmune process, or ovarian toxins; however, in the vast majority of cases, a clear cause is never identified.

• #28 Premature ovarian failure | Orphanet Journal of Rare Diseases | Full Text

  https://ojrd.biomedcentral.com/articles/10.1186/1750-1172-1-9

  Premature ovarian failure (POF) is a primary ovarian defect characterized by absent menarche (primary amenorrhea) or premature depletion of ovarian follicles before the age of 40 years (secondary amenorrhea). It is a heterogeneous disorder affecting approximately 1% of women 40 years, 1:10,000 women by age 20 and 1:1,000 women by age 30. […] POF affects approximately: one in 10,000 women by age 20; one in 1,000 women by age 30; one in 100 women by age 40. The familial form of POF is rare, representing 4 to 31% of all cases of POF. […] The early diagnosis of familial POF will provide the opportunity to predict the likelihood of early menopause, and allow other reproductive choices to be made, such as freezing embryos or having children earlier. As POF has cumulative negative effects over time, it is important for clinicians to make a timely diagnosis and begin appropriate strategies for symptom management, emotional support, and risk reduction.

• #29 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  The proportion of women that primary ovarian insufficiency (POI) impacts do not mirror the devastating effects that this disease spectrum causes. POI affects approximately 1 to 2% of women under the age of 40 and even fewer women under the age of 30 (approximately 0.1%). […] The course of POI is variable and unpredictable. As such, approximately 4-10% of women with POI may conceive naturally and approximately 20% will have successful ovulation induction. However, due to the variability of the disease, the overall success of pregnancy and live birth only reaches 25% after cryopreservation and implantation of embryos. […] Within families who are affected by Fragile X Syndrome, 13-15% have the FMR1 premutation and POI. Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI.

• #30 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI. In addition, therein lies a 24% chance that women will the FMR1 premutation (55-199 CGG repeats) will develop POI. […] In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #31 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI. In addition, therein lies a 24% chance that women will the FMR1 premutation (55-199 CGG repeats) will develop POI. […] In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #32 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  The proportion of women that primary ovarian insufficiency (POI) impacts do not mirror the devastating effects that this disease spectrum causes. POI affects approximately 1 to 2% of women under the age of 40 and even fewer women under the age of 30 (approximately 0.1%). […] The course of POI is variable and unpredictable. As such, approximately 4-10% of women with POI may conceive naturally and approximately 20% will have successful ovulation induction. However, due to the variability of the disease, the overall success of pregnancy and live birth only reaches 25% after cryopreservation and implantation of embryos. […] Within families who are affected by Fragile X Syndrome, 13-15% have the FMR1 premutation and POI. Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI.

• #33 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #34 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI. In addition, therein lies a 24% chance that women will the FMR1 premutation (55-199 CGG repeats) will develop POI. […] In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #35 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #36 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI. In addition, therein lies a 24% chance that women will the FMR1 premutation (55-199 CGG repeats) will develop POI. […] In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #37 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #38 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI. In addition, therein lies a 24% chance that women will the FMR1 premutation (55-199 CGG repeats) will develop POI. […] In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #39 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #40 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI. In addition, therein lies a 24% chance that women will the FMR1 premutation (55-199 CGG repeats) will develop POI. […] In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #41 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #42 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI. In addition, therein lies a 24% chance that women will the FMR1 premutation (55-199 CGG repeats) will develop POI. […] In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #43 Primary Ovarian Insufficiency – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK589674/

  In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #44 Primary Ovarian Insufficiency | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/136054

  Overall, in women with no family history of Fragile X Syndrome, 2-5% will have the FMR1 premutation associated with POI. In addition, therein lies a 24% chance that women will the FMR1 premutation (55-199 CGG repeats) will develop POI. […] In regards to autoimmune disorders, thyroid autoimmunity in the absence of adrenal pathology is responsible for 14-27% of POI, insulin-dependent diabetes mellitus is seen in 2% of cases, and antibodies targeting acetylcholine receptors in myasthenia gravis is in 2% of cases. […] In children previously affected by malignancy and who have received chemotherapy/radiation, approximately 8% will develop POI by the age of 18. If radiation in combination with alkylating agents is used, then the risk of POI jumps to 30%. Lastly, 50% of women 21 years of age or older treated with similar alkylating agents will have POI.

• #45 Primary Ovarian Insufficiency: Time to Diagnosis and a Review of Current Literature

  https://www.imrpress.com/journal/CEOG/49/6/10.31083/j.ceog4906129/htm

  Early diagnosis is imperative to the proper treatment and management of POI, as POI has been linked with other comorbidities including low bone density, depression, and increased risk of cardiovascular disease. A substantial delay between presentation of symptoms and the diagnosis of POI is not uncommon—most experiencing about a 5-year delay between symptom onset and diagnosis, and may be attributed to insufficient understanding and awareness regarding the condition, on the part of women as well as their providers. Indeed, a large cross-sectional study from the Korea National Health and Nutrition Examination Survey demonstrated a significantly increased prevalence of POI in patients with lower socioeconomic status. Delay in diagnosis proves detrimental to patient care, as it results in delayed treatment for comorbidities, which can ultimately increase the risk for all-cause mortality in women with POI.

• #46 Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With th

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5569686/

  A number of clinical practice guidelines have already been developed by groups in North America and Europe to facilitate the early detection and management of POI. […] Recognizing the importance of a global consensus in the approach for POI surveillance, an international effort was organized to harmonize the existing screening recommendations for female survivors of CAYA cancer. […] The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer. […] The working group has agreed that for at-risk pre- and peripubertal survivors, the monitoring of growth and pubertal development and progression is recommended (strong recommendation). […] For postpubertal females who were treated with alkylating agents and/or radiotherapy to which the ovaries were potentially exposed, we recommend detailed menstrual history and physical examination, with specific attention paid to POI symptoms, for example, amenorrhea, but also irregular cycles as a first sign of the development of POI (strong recommendation).

• #47 Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With th

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5569686/

  A number of clinical practice guidelines have already been developed by groups in North America and Europe to facilitate the early detection and management of POI. […] Recognizing the importance of a global consensus in the approach for POI surveillance, an international effort was organized to harmonize the existing screening recommendations for female survivors of CAYA cancer. […] The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer. […] The working group has agreed that for at-risk pre- and peripubertal survivors, the monitoring of growth and pubertal development and progression is recommended (strong recommendation). […] For postpubertal females who were treated with alkylating agents and/or radiotherapy to which the ovaries were potentially exposed, we recommend detailed menstrual history and physical examination, with specific attention paid to POI symptoms, for example, amenorrhea, but also irregular cycles as a first sign of the development of POI (strong recommendation).

• #48

  https://scholars.duke.edu/display/pub1242229

  Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). […] The harmonized POI surveillance recommendations were developed by using a transparent process and are intended to facilitate care for survivors of CAYA cancer. […] The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer.

• #49 Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With th

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5569686/

  A number of clinical practice guidelines have already been developed by groups in North America and Europe to facilitate the early detection and management of POI. […] Recognizing the importance of a global consensus in the approach for POI surveillance, an international effort was organized to harmonize the existing screening recommendations for female survivors of CAYA cancer. […] The harmonized set of POI surveillance recommendations is intended to be scientifically rigorous, to positively influence health outcomes, and to facilitate the care for female survivors of CAYA cancer. […] The working group has agreed that for at-risk pre- and peripubertal survivors, the monitoring of growth and pubertal development and progression is recommended (strong recommendation). […] For postpubertal females who were treated with alkylating agents and/or radiotherapy to which the ovaries were potentially exposed, we recommend detailed menstrual history and physical examination, with specific attention paid to POI symptoms, for example, amenorrhea, but also irregular cycles as a first sign of the development of POI (strong recommendation).

• #50 Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With th

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5569686/

  Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). […] The risk of nonsurgical premature ovarian insufficiency (POI) also referred to as primary ovarian insufficiency, premature ovarian failure or premature menopause among survivors of CAYA cancer is increased compared with sibling controls, with a cumulative incidence of approximately 8% by age 40 years. […] Survivors who are at risk for ovarian dysfunction related to their cancer treatment, and their health care providers, will benefit from clinical practice guidelines that address long-term surveillance for POI to assure survivors timely access to interventions that may preserve health and quality of survival.

• #51 Primary ovarian insufficiency in cancer survivors: Keys to optimal management | Anales de Pediatría

  https://analesdepediatria.org/en-primary-ovarian-insufficiency-in-cancer-articulo-S2341287923002612

  Primary ovarian insufficiency (POI) carries significant morbidity, causing infertility, sexual disfunction, decreased bone density, cardiovascular risk, emotional distress and early mortality. […] The prevalence of POI in the general population is approximately 1.8%. It is greater in patients with cancer or diseases requiring chemotherapy and/or radiation therapy. In the current literature, some studies have reported that the incidence of POI is 3.5 times greater in girls and female adolescents who are cancer survivors compared to their peers. […] Close monitoring of ovarian function in girls and women exposed to gonadotoxic treatments is important, as it offers the opportunity of pursuing fertility preservation options, especially in cases in which it was not possible to do so before initiation of treatment.

• #52 Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With th

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5569686/

  Female survivors of childhood, adolescent, and young adult (CAYA) cancer who were treated with alkylating agents and/or radiation, with potential exposure of the ovaries, have an increased risk of premature ovarian insufficiency (POI). […] The risk of nonsurgical premature ovarian insufficiency (POI) also referred to as primary ovarian insufficiency, premature ovarian failure or premature menopause among survivors of CAYA cancer is increased compared with sibling controls, with a cumulative incidence of approximately 8% by age 40 years. […] Survivors who are at risk for ovarian dysfunction related to their cancer treatment, and their health care providers, will benefit from clinical practice guidelines that address long-term surveillance for POI to assure survivors timely access to interventions that may preserve health and quality of survival.

• #53 Primary ovarian insufficiency in cancer survivors: Keys to optimal management | Anales de Pediatría

  https://analesdepediatria.org/en-primary-ovarian-insufficiency-in-cancer-articulo-S2341287923002612

  Primary ovarian insufficiency (POI) carries significant morbidity, causing infertility, sexual disfunction, decreased bone density, cardiovascular risk, emotional distress and early mortality. […] The prevalence of POI in the general population is approximately 1.8%. It is greater in patients with cancer or diseases requiring chemotherapy and/or radiation therapy. In the current literature, some studies have reported that the incidence of POI is 3.5 times greater in girls and female adolescents who are cancer survivors compared to their peers. […] Close monitoring of ovarian function in girls and women exposed to gonadotoxic treatments is important, as it offers the opportunity of pursuing fertility preservation options, especially in cases in which it was not possible to do so before initiation of treatment.

• #54 Primary ovarian insufficiency in cancer survivors: Keys to optimal management | Anales de Pediatría

  https://analesdepediatria.org/en-primary-ovarian-insufficiency-in-cancer-articulo-S2341287923002612

  The Childrens Oncology Group (COG), the PanCare consortium and other institutions have published guidelines developed by experts for the surveillance and management of adverse events in survivors. […] The use of the tools currently available to estimate the risk of POI allows the education of patients and/or families regarding potential adverse events and can guide the development of a follow-up plan, including monitoring and referral to the appropriate specialists. There is significant room for improvement in this field in Spain, and improvement could yield substantial health benefits.

• #55 Premature ovarian failure after cancer treatment: surveillance and management | ECE2024 | 26th European Congress of Endocrinology | Endocrine Abstracts

  https://www.endocrine-abstracts.org/ea/0099/ea0099ep549

  Premature ovarian failure after cancer treatment: surveillance and management […] Early diagnosis and treatment of ovarian failure avoids cardiovascular disorders, osteoporosis and compromised sexual health due to estrogen deficiency and also ensures growth and pubertal development in children. […] Assessment of ovarian function must be performed after cancer treatments with potential risk of inducing ovarian insufficiency.

• #56 Premature ovarian insufficiency – aetiopathology, epidemiology, and diagnostic evaluation

  https://www.termedia.pl/Premature-ovarian-insufficiency-aetiopathology-epidemiology-and-diagnostic-evaluation,4,33841,1,1.html

  The aetiopathology of premature ovarian insufficiency in the majority of cases is unknown and is termed as spontaneous or idiopathic POI. Some underlying reasons for POI have been established. Most authors group them considering the following aspects: genetic abnormalities, metabolism disorders, autoimmunity, iatrogenic procedures, infections, and environmental factors. […] Criteria for POI diagnosis are the occurrence of clinical symptoms, amenorrhoea, or rare menstruation for at least four months and increased FSH levels 25 IU/l (repeated at four-week intervals). The FSH serum level is the gold standard test in POI diagnosis.

• #57 Premature ovarian insufficiency – aetiopathology, epidemiology, and diagnostic evaluation

  https://www.termedia.pl/Premature-ovarian-insufficiency-aetiopathology-epidemiology-and-diagnostic-evaluation,4,33841,1,1.html

  The aetiopathology of premature ovarian insufficiency in the majority of cases is unknown and is termed as spontaneous or idiopathic POI. Some underlying reasons for POI have been established. Most authors group them considering the following aspects: genetic abnormalities, metabolism disorders, autoimmunity, iatrogenic procedures, infections, and environmental factors. […] Criteria for POI diagnosis are the occurrence of clinical symptoms, amenorrhoea, or rare menstruation for at least four months and increased FSH levels 25 IU/l (repeated at four-week intervals). The FSH serum level is the gold standard test in POI diagnosis.

• #58

  https://journals.lww.com/abhs/fulltext/2024/03030/overview_of_prevalence,_etiology,_clinical.2.aspx

  Approximately 1%2% of women develop hypergonadotropic hypogonadism before reaching the age of 40 years. The prevalence of POI is expected to drop by a factor of 10 every decade before the age of 40 years; therefore, 1% of women under the age of 40 years and 0.1% of women under 30 years of age are affected. […] Diagnosis and subsequent management can be delayed owing to variations in clinical manifestations and, more importantly, the lack of public awareness regarding this condition. […] Given the significant amount of research on this subject, this review aims to cover the most up-to-date scientific data regarding POI, including its etiology, long-term effects, and management options, to provide accurate and precise information for health-care providers and the general population. […] The diagnosis is completed using transvaginal ultrasound to evaluate the ovarian reserve, which shows low antral follicle counts and small ovarian volumes with a thin endometrial echo.

• #59 Primary Ovarian Insufficiency | Concise Medical Knowledge

  https://www.lecturio.com/concepts/primary-ovarian-insufficiency/

  Primary ovarian insufficiency is primarily idiopathic. […] 90% of cases are idiopathic. […] 10%-15% of women have an affected first-degree relative. […] Primary ovarian insufficiency is the depletion or dysfunction of ovarian follicles resulting in cessation of ovulation prior to age 40. […] The disorder is accompanied by high levels of FSH prior to age 40. […] Incidence: 1:100 women by age 40, 1:250 women by age 35. […] Once the diagnosis of POI is made, screening for autoimmune adrenal antibodies and a karyotype should be obtained. […] Management includes hormone replacement therapy, addressing fertility concerns as desired, and psychological support. […] Primary ovarian insufficiency can be caused by chromosomal and genetic defects, an autoimmune process, or ovarian toxins; however, in the vast majority of cases, a clear cause is never identified.

• #60 Primary Ovarian Insufficiency | Concise Medical Knowledge

  https://www.lecturio.com/concepts/primary-ovarian-insufficiency/

  Symptoms of menopause that can also be seen in POI include hot flushes, night sweats, sleep disturbances, vaginal dryness, and mood disturbances. […] Diagnosis requires the patient to be 40 years of age, have oligomenorrhea or amenorrhea for at least 4 months, and elevated FSH levels. […] Follow-up testing once POI is diagnosed includes karyotype, FMR1 premutation screen, and anti-adrenal antibodies. […] Hormone replacement therapy is required to prevent osteoporosis and cardiovascular disease. […] Fertility assistance may be needed if desired. […] Screening for and treating complications such as adrenal insufficiency, autoimmune hypothyroidism, osteoporosis, and cardiovascular disease is important.

• #61

  https://journals.lww.com/abhs/fulltext/2024/03030/overview_of_prevalence,_etiology,_clinical.2.aspx

  POI should be managed using a multidisciplinary approach involving a gynecologist, endocrinologist, and psychologist and should target both physical and psychological consequences. […] Hormonal replacement therapy (HRT) is the mainstay treatment for women with POI. Women should start HRT soon after diagnosis and continue the therapy until the average age of menopause unless they have an absolute contraindication. […] The association between HRT and the risk of cardiovascular disease (CVD) has been controversial; however, many studies and trials have shown that different HRT formulations, doses, and routes of delivery, as well as the age and time since menopause, influence the risk-benefit ratio of HRT with respect to CVD. […] Accepting the diagnosis of POI can be challenging due to feelings of intense grief and loss, as women’s life plans and dreams regarding future pregnancies are altered.

• #62 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] Primary ovarian insufficiency is a pathologic condition that should not be considered a hastening of natural menopause. […] Although women with primary ovarian insufficiency share common health risks with naturally menopausal women, the approach to health maintenance in these women is distinct.

• #63 Primary Ovarian Insufficiency | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/primary-ovarian-insuffiency

  Because women with POI have low levels of estrogen at a young age, several health problems are more common than in women without POI: Infertility: Most women with POI cannot get pregnant naturally. They often can carry a pregnancy but most need to use donor eggs. Osteoporosis: Low levels of estrogen increase the risk of bone loss and fractures. Heart Disease: Low estrogen early in life appears to increase the risk of heart attack as a woman ages. Depression: Many women with POI feel sadness about their unexpected loss of ovarian function. Women with POI should talk about these feelings with their medical provider and may want to talk to a therapist. […] If you have POI, you may also be more likely to develop other hormone-related disorders. Women with POI should be checked periodically for deficiencies in thyroid and adrenal gland hormones.

• #64 Primary Ovarian Insufficiency May Increase Breast, Reproductive Cancer Risk

  https://www.cancernetwork.com/view/primary-ovarian-insufficiency-may-increase-breast-reproductive-cancer-risk

  Findings from a population-based study suggest patients with POI may need genetic counseling regarding future risk of reproductive cancers. […] Patients with primary ovarian insufficiency (POI), defined as primary hypogonadism before turning 40 years old, may be at a greater risk for reproductive cancers, including breast, according to findings from a case-control population-based study published in The Journal of Clinical Endocrinology and Metabolism. […] Data from the study showed a statistically significant increase in breast cancer prevalence in those with POI (relative risk [RR], 2.20; 95% CI, 1.30-3.47; P = .0023), as well as nominal increases in both ovarian (RR, 3.67; 95% CI, 1.00-10.71; P = .050) and uterine cancer (RR, 1.40; 95% CI, 0.17-5.07; P = .66). […] We demonstrate an increase in breast cancer risk compared [with] population rates in [patients] with POI.

• #65

  https://journals.lww.com/abhs/fulltext/2024/03030/overview_of_prevalence,_etiology,_clinical.2.aspx

  POI should be managed using a multidisciplinary approach involving a gynecologist, endocrinologist, and psychologist and should target both physical and psychological consequences. […] Hormonal replacement therapy (HRT) is the mainstay treatment for women with POI. Women should start HRT soon after diagnosis and continue the therapy until the average age of menopause unless they have an absolute contraindication. […] The association between HRT and the risk of cardiovascular disease (CVD) has been controversial; however, many studies and trials have shown that different HRT formulations, doses, and routes of delivery, as well as the age and time since menopause, influence the risk-benefit ratio of HRT with respect to CVD. […] Accepting the diagnosis of POI can be challenging due to feelings of intense grief and loss, as women’s life plans and dreams regarding future pregnancies are altered.

• #66

  https://journals.lww.com/abhs/fulltext/2024/03030/overview_of_prevalence,_etiology,_clinical.2.aspx

  POI should be managed using a multidisciplinary approach involving a gynecologist, endocrinologist, and psychologist and should target both physical and psychological consequences. […] Hormonal replacement therapy (HRT) is the mainstay treatment for women with POI. Women should start HRT soon after diagnosis and continue the therapy until the average age of menopause unless they have an absolute contraindication. […] The association between HRT and the risk of cardiovascular disease (CVD) has been controversial; however, many studies and trials have shown that different HRT formulations, doses, and routes of delivery, as well as the age and time since menopause, influence the risk-benefit ratio of HRT with respect to CVD. […] Accepting the diagnosis of POI can be challenging due to feelings of intense grief and loss, as women’s life plans and dreams regarding future pregnancies are altered.

• #67 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Treatment for all women with primary ovarian insufficiency should continue until the average age of natural menopause is reached (age 5051 years). […] The focus of this Committee Opinion is to review the medical and psychosocial risks facing women with primary ovarian insufficiency and to discuss the various HT treatment options available. […] Epidemiologic evidence supporting the use of HT to prevent cardiovascular events in women with primary ovarian insufficiency is currently lacking. […] Data specifically evaluating the use of combined hormonal contraceptives in women with primary ovarian insufficiency are lacking, so care should be individualized to the needs of each patient. […] Primary ovarian insufficiency is a life-altering diagnosis that presents numerous medical and psychosocial challenges for affected women.

• #68 Primary Ovarian Insufficiency | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/primary-ovarian-insuffiency

  Treatment depends on whether you have symptoms or are at risk for serious health problems. Hormone therapy (HT) is the most common treatment. HT combines estrogen and progesterone, another sex hormone. HT relieves menopausal symptoms and also helps prevent osteoporosis. HT can be taken as a pill or applied to your skin as a patch. Vaginal rings can also supply estrogen to the body. In older, postmenopausal women, HT may increase risk of breast cancer, heart disease, and stroke. In younger women with POI, these risks are thought to be much lower, since it’s normal for women in this age group to have higher estrogen levels. Usually, HT is stopped when a woman with POI reaches the age of natural menopause (around age 50). If you cannot or do not want to take HT, you might benefit from non-hormonal treatments. In addition to medical treatment, you can lower your risk of osteoporosis and heart disease by eating a healthy diet and exercising regularly.

• #69 Hormone Therapy in Primary Ovarian Insufficiency | ACOG

  https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/05/hormone-therapy-in-primary-ovarian-insufficiency

  Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. […] In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment. […] Hormone therapy is indicated to reduce the risk of osteoporosis, cardiovascular disease, and urogenital atrophy and to improve the quality of life of women with primary ovarian insufficiency. […] Primary ovarian insufficiency is a pathologic condition that should not be considered a hastening of natural menopause. […] Although women with primary ovarian insufficiency share common health risks with naturally menopausal women, the approach to health maintenance in these women is distinct.

• #70 Factors leading to primary ovarian insufficiency: a literature overview – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/02-2021/factors-leading-to-primary-ovarian-insufficiency-a-literature-overview/

  Early diagnosis is key in the management of young patients with primary POI, as it allows the establishment of a proper hormone replacement therapy. […] Patients with primary POI must be informed and counselled with regard to their fertility preservation options. […] This literature overview underlines that early diagnosis is key in the management of young patients suffering from primary POI, as it allows the establishment of a proper hormone replacement therapy.

• #71 Primary Ovarian Insufficiency: Time to Diagnosis and a Review of Current Literature

  https://www.imrpress.com/journal/CEOG/49/6/10.31083/j.ceog4906129/htm

  Early diagnosis is imperative to the proper treatment and management of POI, as POI has been linked with other comorbidities including low bone density, depression, and increased risk of cardiovascular disease. A substantial delay between presentation of symptoms and the diagnosis of POI is not uncommon—most experiencing about a 5-year delay between symptom onset and diagnosis, and may be attributed to insufficient understanding and awareness regarding the condition, on the part of women as well as their providers. Indeed, a large cross-sectional study from the Korea National Health and Nutrition Examination Survey demonstrated a significantly increased prevalence of POI in patients with lower socioeconomic status. Delay in diagnosis proves detrimental to patient care, as it results in delayed treatment for comorbidities, which can ultimately increase the risk for all-cause mortality in women with POI.

• #72 Primary Ovarian Insufficiency: Time to Diagnosis and a Review of Current Literature

  https://www.imrpress.com/journal/CEOG/49/6/10.31083/j.ceog4906129/htm

  Our study illustrates a substantial delay in diagnosis, specifically in an underserved community consisting of largely underrepresented minority women who lack easy access to a reproductive endocrinologist. To our knowledge, this study is the first to assess time to diagnosis of POI specifically in a population of underinsured, underrepresented minority women who face multiple barriers to care. Median time to diagnosis in our patient population was 48 months, a disheartening result given the lost opportunity for early treatment, especially since 35.7% of patients that underwent DEXA screening had osteopenia or osteoporosis and 73.6% of total patients were nulliparous.

• #73 Primary ovarian insufficiency: an update | IJWH

  https://www.dovepress.com/primary-ovarian-insufficiency-an-update-peer-reviewed-fulltext-article-IJWH

  POI can be associated with a variety of autoimmune disorders, most commonly thyroiditis. […] Current studies have failed to determine specific biomarkers or signs/symptoms of POI that will accurately predict when menopause will occur. […] Unfortunately, standardized diagnostic criteria for POI have yet to be established. […] A multidimensional approach should be undertaken to manage POI. […] Management should reflect a comprehensive approach, including providing hormone replacement therapy, fertility management, and physical or emotional support. […] The need for long-term follow-up of this population with preventive maintenance therapy and periodic surveillance cannot be overemphasized.

• #74 Factors leading to primary ovarian insufficiency: a literature overview – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/02-2021/factors-leading-to-primary-ovarian-insufficiency-a-literature-overview/

  Early diagnosis is key in the management of young patients with primary POI, as it allows the establishment of a proper hormone replacement therapy. […] Patients with primary POI must be informed and counselled with regard to their fertility preservation options. […] This literature overview underlines that early diagnosis is key in the management of young patients suffering from primary POI, as it allows the establishment of a proper hormone replacement therapy.

• #75 Factors leading to primary ovarian insufficiency: a literature overview – GREM – Gynecological and Reproductive Endocrinology & Metabolism

  https://gremjournal.com/journal/02-2021/factors-leading-to-primary-ovarian-insufficiency-a-literature-overview/

  Early diagnosis is key in the management of young patients with primary POI, as it allows the establishment of a proper hormone replacement therapy. […] Patients with primary POI must be informed and counselled with regard to their fertility preservation options. […] This literature overview underlines that early diagnosis is key in the management of young patients suffering from primary POI, as it allows the establishment of a proper hormone replacement therapy.

• #76 Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With th

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5569686/

  The recommendations outlined in this article are for primary surveillance rather than for treatment options; however, because of the health problems induced by estrogen deprivation in patients with POI in the general population, it is important to consider sex hormone replacement therapy for survivors of CAYA cancer with POI because of its benefit to sexual function, bone health, and cardiovascular health. […] The highlighting of a research agenda by identifying key gaps in knowledge is an important result of the harmonization process.

• #77 Endocrinology of Primary Ovarian Insufficiency: Diagnostic and Therapeutic Clues

  https://www.mdpi.com/2673-396X/6/2/18

  A specific pattern of endocrine disorders, characterized by high-serum FSH and low E2 concentrations, is a typical feature of POI and is decisive for POI diagnosis. […] The estimated global prevalence of POI is 3.7%, but this has been steadily increasing in recent years. […] Improving the diagnostic and therapeutic methods to be employed in cases of POI is thus an important challenge for future research. […] Early diagnosis is particularly important in women with a familial history of POI in whom the disease risk is significantly higher as compared to general population; this risk is 18-fold, 4-fold, and 2.7-fold higher for first-degree, second-degree, and third-degree relatives, respectively. […] The diagnosis of POI is mainly based on the evaluation of endocrine parameters. […] The treatment of general health problems, based on correcting hypoestrogenism through hormone replacement therapy (HRT), is relatively easy. […] Oocyte donation is the recommended treatment for infertility due to POI, as it has been proven to achieve a 70–80% successful pregnancy rate in patients suffering from this pathology. […] Innovative treatment alternatives are currently under investigation.

• #78 Endocrinology of Primary Ovarian Insufficiency: Diagnostic and Therapeutic Clues

  https://www.mdpi.com/2673-396X/6/2/18

  A specific pattern of endocrine disorders, characterized by high-serum FSH and low E2 concentrations, is a typical feature of POI and is decisive for POI diagnosis. […] The estimated global prevalence of POI is 3.7%, but this has been steadily increasing in recent years. […] Improving the diagnostic and therapeutic methods to be employed in cases of POI is thus an important challenge for future research. […] Early diagnosis is particularly important in women with a familial history of POI in whom the disease risk is significantly higher as compared to general population; this risk is 18-fold, 4-fold, and 2.7-fold higher for first-degree, second-degree, and third-degree relatives, respectively. […] The diagnosis of POI is mainly based on the evaluation of endocrine parameters. […] The treatment of general health problems, based on correcting hypoestrogenism through hormone replacement therapy (HRT), is relatively easy. […] Oocyte donation is the recommended treatment for infertility due to POI, as it has been proven to achieve a 70–80% successful pregnancy rate in patients suffering from this pathology. […] Innovative treatment alternatives are currently under investigation.

• #79 Endocrinology of Primary Ovarian Insufficiency: Diagnostic and Therapeutic Clues

  https://www.mdpi.com/2673-396X/6/2/18

  A specific pattern of endocrine disorders, characterized by high-serum FSH and low E2 concentrations, is a typical feature of POI and is decisive for POI diagnosis. […] The estimated global prevalence of POI is 3.7%, but this has been steadily increasing in recent years. […] Improving the diagnostic and therapeutic methods to be employed in cases of POI is thus an important challenge for future research. […] Early diagnosis is particularly important in women with a familial history of POI in whom the disease risk is significantly higher as compared to general population; this risk is 18-fold, 4-fold, and 2.7-fold higher for first-degree, second-degree, and third-degree relatives, respectively. […] The diagnosis of POI is mainly based on the evaluation of endocrine parameters. […] The treatment of general health problems, based on correcting hypoestrogenism through hormone replacement therapy (HRT), is relatively easy. […] Oocyte donation is the recommended treatment for infertility due to POI, as it has been proven to achieve a 70–80% successful pregnancy rate in patients suffering from this pathology. […] Innovative treatment alternatives are currently under investigation.

• #80 Recommendations for Premature Ovarian Insufficiency Surveillance for Female Survivors of Childhood, Adolescent, and Young Adult Cancer: A Report From the International Late Effects of Childhood Cancer Guideline Harmonization Group in Collaboration With th

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5569686/

  The recommendations outlined in this article are for primary surveillance rather than for treatment options; however, because of the health problems induced by estrogen deprivation in patients with POI in the general population, it is important to consider sex hormone replacement therapy for survivors of CAYA cancer with POI because of its benefit to sexual function, bone health, and cardiovascular health. […] The highlighting of a research agenda by identifying key gaps in knowledge is an important result of the harmonization process.

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