POI causes infertility for most women with the condition. At this time, there is no proven medical treatment that improves your ability to get pregnant naturally if you have POI.1
If you have been diagnosed with POI, don't rush into making decisions about family planning. Take time to talk with your health care provider and to research your options. Share your feelings with your partner, and listen to your partner's feelings.2
If you have POI and want to have children, consider the following options:
See if pregnancy occurs naturally. Between 5% and 10% of women with POI do get pregnant, even though they have not had fertility treatment. Sometimes pregnancy can occur many years after the initial POI diagnosis. Researchers don't know why some women with POI get pregnant while others do not, and researchers can't predict which women will get pregnant.3
Adoption or foster parenting. When considering adoption or foster parenting, it's important to learn about the benefits, risks, and legal aspects of the process, in addition to the possible emotional effects. For more information about adoption, consult the resources in the Resources and Publications section.
Donor Eggs. Research has shown that in vitro (pronounced in VEE-troh) fertilization (IVF) with donor eggs is an effective way for women who have POI to get pregnant.1
IVF with donor eggs involves removing eggs from another woman's ovary, then fertilizing the eggs with sperm in a laboratory. A fertilized egg—called an embryo (pronounced EM-bree-oh)—is then placed into your uterus. During the IVF process, the donor takes hormones to prepare for egg donation, and you take hormones to prepare your body for pregnancy.4
Sometimes, more than one embryo is placed into the uterus to increase the likelihood of a successful pregnancy. More eggs may be fertilized than are transferred; you may choose to freeze extra embryos, called cryopreservation (pronounced krahy-oh-prez-er-VEY-shuhn), in case you try IVF again.5
IVF with donor eggs, like all medical procedures, has benefits and risks, some of them serious.4 Some studies suggest that women with POI who get pregnant with egg donation may have a higher risk of delivering a baby that is small for its gestational age (smaller than the usual size of babies that far along in pregnancy). They may also be more likely to have pregnancy-related high blood pressure3 and heavy bleeding after giving birth. More studies are needed to understand these risks and their relationship to POI. Discuss all the risks and benefits with your health care provider and your family before making a decision about IVF with donor eggs.
Not all insurance companies provide coverage for IVF and donor eggs, so it may be necessary for you to cover the entire cost of the process. Also, it may be necessary to try the procedure several times before it is successful.4
Medical Therapies that Don't Work for POI-related Infertility
Randomized clinical trials, which are the strongest type of trial measuring a treatment's impact, have proven that some medical therapies for infertility—including infertility related to POI—are ineffective. These medical therapies include treatments based on high-dose estrogen, corticosteroids, gonadotropin-releasing hormone agonists and antagonists, as well as treatment with a type of testosterone called danazol (Danocrine®). Health care providers recommend avoiding unproven fertility treatments because they actually may reduce your chances of getting pregnant naturally.
If You have POI and Do Not Want to Become Pregnant
Remember that pregnancy can occur in women who have POI. Therefore, if you do not want to get pregnant, you need to take steps to prevent pregnancy by using contraception (birth control).
Because of problems with ovulation that are associated with POI, birth control pills may not be effective at preventing pregnancy in women with POI. Studies show that using a barrier method of contraception, such as a diaphragm or a condom, is a more effective option.4 Discuss your birth control needs with your health care provider.