Pregnancy in Primary Ovarian Insufficiency and Hypoplastic Uterus: Case Series
Author(s):
Dr. Saurav Prakash Maity, Dr. Bishista Bagchi and Dr. Apurba Pailan
Primary ovarian insufficiency (POI) in women of reproductive age remains unexplained in nearly 90% of cases. Various infections (e.g., mumps, varicella, malaria, shigella, tuberculosis) can destroy healthy ovarian tissue. Rare mutations in genes for FSH and LH receptors, chromosomal abnormalities (e.g., Turner Syndrome, Mosaic Turners, Fragile X FMR1 premutation), and autoimmune diseases (e.g., Addison disease, Hashimoto thyroiditis, rheumatoid arthritis, systemic lupus erythematosus) are also associated with POI. Genetic mutations and autosomal recessive diseases like galactosemia contribute to POI as well.
The overall success rate for pregnancy and live birth after assisted reproductive techniques is only 25%. Women with POI should be informed about their condition and future fertility treatment options.
For women desiring fertility, cyclical bleeding is preferred to maximize chances of successful embryo transfer or natural pregnancy. Premenopausal women are often prescribed OCPs with a placebo week per month, leading to 12 weeks of estrogen deficiency annually. Oocyte donation remains the best option for achieving successful pregnancy in women with POI, with a 40% probability after one IVF cycle and 70-80% after four cycles.