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Premature Ovarian Aging (POA): A Silent Cause of Infertility

The Center for Human Reproduction’s Dr. Vitaly A Kushnir explains that premature ovarian aging (POA) can be a silent form of infertility, as many women with POA have no symptoms.

There can be a number of different causes for this that we can discuss in-depth, but some women age their ovaries faster than others. Other women, the ovarian reserve is depleted by some kind of treatment, for example a woman who has had chemotherapy can deplete her ovarian reserve to a much lower amount than what would be normal. Common tests that are used to define the ovarian reserve are the FSH (follicle stimulating hormone), AMH (Anti-Müllerian hormone), ovarian direct measurements of the ovaries using an ultrasound, for example, where we can actually measure the ovary and see how many antral follicles are remaining within that ovary and the ovarian volume. These are probably the most common tests that are used these days to determine the ovarian reserve. Many patients will have no symptoms of premature ovarian aging or diminished ovarian reserve, so often it’s discovered accidentally by one of their treating physicians. Sometimes women will present because of infertility, and this is discovered as one of the main causes of infertility. At other times, it’s discovered because a woman starts having irregular menstrual cycles and this can be an early warning sign that she’s developing this problem, and sometimes it’s discovered as part of evaluation for some kind of gynecological problem, for example if somebody has cysts on their ovaries and this is discovered in the process.