Patient Resources

Primary Ovarian Insufficiency (Premature Ovarian Failure)

Primary ovarian insufficiency (POI), also known as premature ovarian failure, is a potential cause of female infertility in which women do not ovulate regularly and are unlikely to conceive with their own eggs. Women with POI experience clinical signs, and sometimes symptoms, of menopause before the age of 40, whereas the average age of menopause is between 48 and 55. The risk of diagnosis increases with age, as 1 in 1,000 women ages 15-29 are diagnosed, 2 in 250 women ages 30-35, and 1 in 100 women ages 35-40.

Why Is It Difficult to Conceive with POI?

Women with primary ovarian insufficiency’s ovaries do not function as expected. There may be fewer follicles than women their age should have, whereas the ovaries of a healthy adult woman contain tens of thousands of follicles, each holding a potential egg. A woman with POI’s antral follicle count, which estimates the general total of available follicles in the ovaries, will be low. Their ovaries and follicles will not respond effectively to the hormones that stimulate egg maturation and ovulation, and the ovaries may fail to produce normal levels of estrogen, causing fertility drugs to be ineffective.

Fertility drugs require that there be enough follicles in the ovaries to be stimulated, and the follicles must respond when exposed to ovulation-stimulating hormones. For women with POI, the follicles do not fully respond to fertility drugs. Even if the drugs do trigger ovulation, the eggs may be poor quality, making fertilization and pregnancy less likely.

Symptoms of POI

Women can have varying degrees of symptoms, but the most common symptom is irregular periods. Other symptoms can include:

  • Having no periods (amenorrhea)
  • Having infrequent periods (more than every 35 days)
  • Having irregular periods (varying by more than a few days from month to month)
  • Having unusual menstrual bleeding (spotting or very light periods)

Some women with POI experience symptoms from low estrogen levels, which may include:

  • Low libido
  • Vaginal dryness
  • Painful intercourse
  • Hot flashes and/or night sweats
  • Depression and/or anxiety
  • Insomnia or difficulty sleeping


The North Carolina Center for Reproductive Medicine/Talbert Fertility Institute is the premiere center for reproductive health in North Carolina and the East Coast. Our team specializes in fertility testing, diagnosis, and treatment of infertility conditions. We’re experts in IVF, Tubal Ligation Reversal, Male Infertility, Intrauterine Insemination (IUI), Gestation Surrogacy, Family Balancing, and more. Contact us today.

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