Life plans and family-building options for women with primary ovarian insufficiency.

Primary ovarian insufficiency (POI) compromises a woman's chance of conceiving with her own oocytes. Although biomarkers such as serum follicle-stimulating hormone, serum antimüllerian hormone, and assessment of antral follicle count by transvaginal ultrasound can give some general idea about ovarian activity and perhaps fertility potential, no marker will definitively predict if and when childbearing will be possible for women with POI. No medical therapy has yet been definitively proven to improve ovarian function and fertility for women with overt POI. Fertility preservation, with cryopreservation of ovarian tissue, oocytes, or embryos, can be considered for some women with POI if oocytes are retrievable and current childbearing is not desired, with the caveat that data regarding long-term safety and efficacy are not available for women with POI. Options with a high chance of success are oocyte donation, embryo donation, and adoption. Child-free living may be a reasonable choice for some women. It is beneficial for women with POI to hear all life-plan and family-building options presented in a balanced manner.