Infertility Treatment in Primary Ovarian Insufficiency: Fertility Preservation and In Vitro Activation

Primary ovarian insufficiency (POI) affects about 1% of women in the reproductive age. These women are below 40 years of age, experience amenorrhoea for at least 4 months, and have two readings of serum follicular stimulating hormone (FSH) of more than 40IU/L at one month apart [1-3]. Those who plan to expand their families are mostly left with the option of adoption or oocyte donation. However, donor oocyte is not an option for some of these women due to personal and religious reasons, and is in rare supply. With delayed childbearing being the current norm in Japan and many other countries, where the average age of having the first child has increased to 31 years of age in Japan, sub-fertility is rapidly emerging as a common presentation. Furthermore, this situation is associated with increases in the number of infertile POI patients. Although it is difficult to change the delayed childbearing in modern society, recent advances in reproductive medicine allows us to predict POI before onset of complete amenorrhea, preserve fertility in POI patients, and establish new infertility treatment for POI patients.