No More Eggs: Understanding Ovarian Failure
With time, a woman’s fertility naturally declines. However, for some individuals, ovarian function is reduced much earlier. Known as premature ovarian failure (POF) or primary ovarian insufficiency (POI), the condition occurs when the ovaries stop working correctly before age 40 and don’t release sufficient eggs. Embryo cryopreservation is a great way for women with POI to preserve fertility before the condition makes natural pregnancy impossible.
What is primary ovarian insufficiency?
The exact cause of POI is poorly understood. Genetics likely play a role, and if a mom or sister experienced premature ovarian insufficiency, the chance is thought to be higher. Certain autoimmune diseases, viral infections, and some cancer treatments can also cause ovarian failure. Most women experience POI between ages 35-40, but the condition can happen as early as the teenage years. Symptoms typically include missed or irregular periods, hot flashes or night sweats, vaginal dryness, depression or anxiety, and infertility.
Making the diagnosis
If symptoms of POI are present, and especially if infertility is suspected, a doctor should be consulted. Blood work to check levels of follicle-stimulating hormone (FSH), estradiol, and prolactin, along with an ultrasound, can help collect more information about the current health of the ovaries. No treatment can restore fertility, but if the condition is caught early, embryo cryopreservation can help secure future pregnancy plans.
Turning to cryopreservation
Embryo freezing or cryopreservation is a process that freezes fertilized eggs for use later in life. The woman will be given medication to encourage egg growth and must undergo an egg retrieval to obtain the specimen. In some cases, the egg can be stored alone, but an embryo can also be created by adding a male partner or donor’s sperm. Younger women who have the procedure done proactively typically have higher success rates than women who are already experiencing fertility issues. However, the procedure can still be beneficial for women who identify POI early, have eggs remaining, and desire pregnancy later in life.
Success rates
Each case is unique, and overall success rates will depend on various factors, including how many eggs were retrieved and frozen, medication use, the expertise of the fertility provider, the health of the partner’s sperm, and any other underlying health conditions the woman may have. A recent study shows that among women with POI who underwent an embryo transfer using in vitro fertilization (IVF) with ovarian stimulation, a live birth rate of 5.8% was reported. The authors also point out that women in the study who had experienced irregular periods for less than 4 years were more likely to have success with this approach.
Getting pregnant with POI
Although fertility is significantly compromised, women with primary ovarian failure can still get pregnant in some cases. Embryo cryopreservation can help retrieve and store eggs before additional insufficiency occurs. With IVF, pregnancy is sometimes possible. Older women and individuals with advanced POI should discuss all paths to parenthood with a healthcare provider, including the possibility of adoption or embryo donation if IVF is not a viable option.
