The number of reproductive years among women varies, depending on steroid production by the ovaries. Many of us are aware a woman’s fertility starts decreasing or there are risk of genetic issues in fetus ,once she crosses 35 years of age. The fertility and the functioning of the ovaries start declining over years. However, some women can experience this decline before they turn 40 years. So, is this normal? Can this affect them in any way? Come, let’s find out.
Premature Ovarian Failure, also known as Primary Ovarian Insufficiency (POI) describes a spectrum of declining ovarian function and reduced fecundity due to premature decrease in initial follicle number, an increase destruction, or poor follicular response to gonadotropins. Woman’s ovaries stop functioning properly before she turns 40 years old. When this happens , ovaries don’t produce normal amounts of the hormone estrogen or release eggs regularly. This condition is also called as premature ovarian failure and often leads to infertility .For women with POI, irregular periods and reduced fertility occur before the age of 40, sometimes as early as teenage years.
Menopause is when there is permanent cessation of ovarian function. Premature menopause is diagnosed when women under 40yrs have elevated follicle stimulating hormone levels in menopausal range (at least 30-40mIU/ml) and amenorrhea. Hence women with menopause can never have pregnancy with her own oocytes. POI is a malfunction of the ovaries, 50% of whom can have infrequent ovulation and menstrual cycles after diagnosis and 5-10% of whom may achieve spontaneous pregnancies, while the rest can be managed to a certain extent with treatments like Hormone Replacement Therapy (HRT) and can conceive.
Almost 90% of cases of premature ovarian failure are idiopathic. Certain research shows POI could be mostly due to a malfunctioning of the follicles. Follicles are a part of the ovaries where the eggs grow and mature. A problem with the follicles will affect the health of the eggs. In some cases, women may run out of working follicles and in some, the follicles may not work properly.
Some of the possible reasons for the follicles not working properly could be:
If you have any of the above or a family history of POI, you may be at risk of POI.
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Many women have irregular periods. It can be quite easy to mistake it for something else or just ignore it until it is too late. Here are some ovarian dysfunction symptoms in addition to missed periods, that can indicate primary ovarian insufficiency:
In some cases, symptoms of POI can also indicate secondary amenorrhea – a condition where periods stop and do not resume even after 6 months, despite a negative pregnancy test. In case of secondary amenorrhea, your doctor will suggest an amenorrhea treatment to help resume your menstrual cycle.
Many are aware that in the case of POI-induced infertility, eggs can be insufficient or of low quality. Can POI cause other health issues? Yes, since it is a hormonal imbalance, it can have a multiple effects on your body. Here are some of the health issues POI can trigger:
When you complain of irregular periods and difficulty in getting pregnant, your doctor might ask for the following tests to confirm the diagnosis of primary ovarian insufficiency:
Once your doctor confirms a primary ovarian insufficiency, they might suggest the following treatments:
So, can you get pregnant despite a POI diagnosis? Yes, but the chances are very low. One might even conceive and not know about it for a while.
Since the menstrual cycle is irregular, one may not suspect pregnancy when the menstruation does not start on time. You may get pregnant spontaneously, without having to try much, and in some cases, no matter how hard the couple tries, they may not get pregnant.
If you plan on undergoing any radiation or chemotherapy, you may consider freezing your eggs or embryos. You can use it when you feel ready and your body is up for it. Alternatively, you can use donor eggs and also get pregnant if you find out about your POI late and are unable to get pregnant despite all treatments.
Primary ovarian insufficiency is life altering diagnosis that presents numerous medical psychosocial challenges for affected women. It need not be the end of your pregnancy attempts. You can consult a fertility specialist and get some guidance. With today’s advancement in the field of infertility, one has multiple options to make their family expansion dreams come true. All you need is a good fertility specialist and a well-reputed fertility institution.
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