How does POI affect my fertility?

Premature ovarian insufficiency (POI) (or premature menopause) is a condition where the
number of eggs in the ovaries has severely reduced and the ovaries stop functioning
properly, before the age of 40. As the number of remaining eggs becomes very low, the
ovaries stop releasing an egg each month (ovulating) and so the chance of getting pregnant
is significantly reduced.

Many people with POI are often told that there is no chance of getting pregnant naturally but in
fact this isn’t true. Women with POI may have times where the function of the ovaries can
intermittently return. This occasionally allows ovulation and pregnancy to occur.
Approximately 5-10% of women conceive naturally after a diagnosis of POI.

Is there anything I can do to increase the chances of getting pregnant naturally?

Hormone replacement therapy (HRT) is recommended in women with POI to treat the
symptoms of estrogen deficiency and to protect against the long-term effects such as
osteoporosis or cardiovascular disease. In low-medium doses, HRT is not contraceptive and
will help keep the uterus (womb) and endometrium (womb lining) healthy. By lowering the
follicle stimulating hormone (FSH) levels, HRT may even promote ovulation, particularly in
the earlier stages after diagnosis.

Unfortunately, there are currently no treatments proven
to increase ovulation and the chance of natural pregnancy in women with POI. Supplements
such as DHEA have been suggested to help but have not been proven in clinical trials.
The loss of fertility can, for many women, be one of the most distressing aspects of POI. It is
important that you get help and support through what can be a very difficult time. Your GP
or menopause specialist may suggest seeing a fertility specialist to discuss your options.
Counselling or joining a support group can also be beneficial.