Managing Premature Ovarian Failure
Most women know that fertility declines with age, making conception more difficult. However, for some women, a decline in fertility happens much earlier in life. Premature ovarian insufficiency (POI) or premature ovarian failure is a medical condition where the ovaries stop working normally at age 40 or before. With POI, pregnancy is much more difficult but not impossible. In vitro fertilization (IVF) can help women with POI get pregnant at any age.
Fertility stats
A woman's fertility peaks between the late teens and late 20s, slowly starting to decline in the years that follow. Women over the age of 35 are more likely to have eggs with abnormal chromosomes, making pregnancy less likely. Medical conditions, such as fibroids, are also more likely to occur the older a woman is, negatively impacting fertility. After age 45, natural pregnancy is typically no longer possible. Although most women follow this fertility trajectory, some individuals experience trouble getting pregnant at a younger age.
Understanding POI
For most women, the first sign of POI is a missed or irregular period. Hot flashes, night sweats, decreased sex drive, irritability, and poor concentration are other possible symptoms. A doctor will take a medical history, perform a physical, and order an ultrasound to make an official diagnosis. Blood work to check hormone levels and rule out pregnancy will also be done. In about 90% of cases, the exact cause of POI is unknown. However, women with a family history of POI are more likely to experience an early decline in fertility. Certain autoimmune diseases, viral infections, previous cancer treatment, and toxins such as pesticides have also been linked with the development of premature ovarian insufficiency.
Treating premature failure
There is currently no treatment available to restore the ovaries to normal functioning. However, certain medications can help with symptom management and fertility. Hormone replacement therapy (HRT), containing estrogen, is the most common treatment for POI. By replacing natural hormones the ovaries are no longer making, HRT helps improve sexual health. Hormone replacement therapy, along with supplemental calcium and vitamin D, can also help decrease the risk of osteoporosis. To address fertility concerns, IVF is often the best bet.
IVF baby
Primary ovarian insufficiency means a woman doesn't release eggs regularly, although eggs can still be produced. In fact, some women with POI will go on to get pregnant naturally. When making the decision to undergo IVF, certain fertility medications can help to maximize the number of healthy eggs produced in a single cycle. From there, a retrieval is scheduled to collect the eggs. In the lab, eggs are combined with sperm to create an embryo, which is then transferred back into the uterus in hopes of implantation.
POI isn't the end of the road
Many people associate POI with complete infertility, but that simply isn't the case. Although egg production is reduced in women with ovarian insufficiency, conception is still possible. With IVF, the chances of a successful pregnancy are significantly increased. Acting quickly once a diagnosis of POI is made can result in the best chances of successfully growing a family.
