By definition Premature Ovarian Insufficiency, previously known as Premature Ovarian Failure is considered the depletion or dysfunction of ovarian follicles in females at a younger age of 40 years of age [1]. Ovaries in its normal state have two primary functions:

• To produce hormones for the female reproductive system
• To control development, selection and the maturation of oocyte eventually to be fertilized.

This folliculogenesis begins at an early stage in-utero and later in puberty at the reproductive stage primordial follicles transform through a multi-step process into maturation and pre-ovulatory follicles [2].

The follicular development when it ceases to function properly leads to amenorrhoea (loss of menses) which can occur spontaneously or secondary to medical therapies. Women with POI present menstrual disturbances, menopausal symptoms, infertility and other psychosocial issues.

For a woman to be diagnosed with POI follicle-stimulating hormone (FSH) that is produced in the pituitary gland needs to be measured on two occasions at least 4-6 weeks apart in a woman of lower than 40 years of age after a period of 4 months of amenorrhea or any kind of menstrual irregularity [3]. The FSH test is taken on the 2-3 day of the menstrual cycle to show us the efficiency of the ovaries.

POI affects 1% of female population gradually increasing in the past years of female population.

Spontaneous POI can be associated with chromosomal, genetic, enviromental factors, autoimmune diseases (commonly adrenal or thyroid), various infections or even idiopathic [4].

Although a rare gynecological condition women with POI are advised  as a first line of treatment hormone replacement therapy (HRT) for this disorder though through the years new therapeutic approaches have surfaced with promising results. These new generation therapies include in-vitro activation, mitochondrial activation technique, platelet-rich plasma intraovarian infusion, stem cells and exosomes therapy. Due to the fact that these methods are still in an experimental stage, precise design components are required for their conversion into clinical treatments. We bear a responsibility to every individual for selecting the best suitable therapy in each patient for the best possible outcome [5].

References:

1. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2014/07/primary-ovarian-insufficiency-in-adolescents-and-young-women
2. https://www.ncbi.nlm.nih.gov/books/NBK532300/
3. https://www.racgp.org.au/afp/2017/june/premature-ovarian-insufficiency-in-general-practic
4. https://pubmed.ncbi.nlm.nih.gov/27008889/
5. https://pubmed.ncbi.nlm.nih.gov/35120535/