Premature ovarian insufficiency as a predictor of reduced reproductive potential and the likelihood of pregnancy in women of reproductive age: A literature review
DOI:
https://doi.org/10.37800/RM.3.2026.696Keywords:
Premature ovarian insufficiency (POI), ovarian reserve, infertility, anti-Müllerian hormone, follicle-stimulating hormone, hypoestrogenism, menstrual cycle disordersAbstract
Relevance: Premature ovarian insufficiency (POI) is a significant cause of reduced reproductive potential in women of reproductive age. This condition is characterized by a premature decline in ovarian reserve, disruption of hormonal homeostasis, and loss of fertility before the age of 40. Given the current trend toward delayed motherhood, early identification of predictors of ovarian reserve depletion has gained particular clinical and social importance.
The study aimed to analyze current scientific data on the diagnostic criteria of premature ovarian failure and assess their prognostic significance for determining the reproductive potential of women of reproductive age, as well as generalize international experience of using assisted reproductive technologies in this clinical group.
Materials and Methods: We conducted a literature review of scientific publications from 2015 to 2025 in PubMed, Web of Science, and Google Scholar using the keywords: premature ovarian insufficiency, ovarian reserve, anti-Müllerian hormone (AMH), female infertility, assisted reproductive technologies (ART). We identified 145 publications and selected full-text articles after initial screening, duplicate removal, and assessment of titles and abstracts against the inclusion criteria. We used validated tools to assess study quality, including AMSTAR-2 for systematic reviews. We excluded studies with a high risk of bias or low methodological quality. The review included 33 articles that best reflected the current understanding of POI diagnosis, pathogenesis, and reproductive outcomes.
Results: The key biomarkers of reduced reproductive potential in POI include low AMH levels, elevated follicle-stimulating hormone concentrations, and a decreased antral follicle count. Dysregulated folliculogenesis, mitochondrial dysfunction in granulosa cells, and genetic and inflammatory factors contribute to accelerated ovarian reserve depletion. The likelihood of spontaneous pregnancy decreases but is not entirely ruled out. ART—particularly programs using donor oocytes—demonstrates the highest efficacy.
Conclusion: Timely diagnosis using hormonal and ultrasound markers enables optimized patient management and improves the effectiveness of reproductive interventions. Further research is required to investigate POI etiological mechanisms and to develop personalized prevention and treatment strategies.
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