Premature ovarian failure: a systematic review on therapeutic interventions to restore ovarian function and achieve pregnancy.

Infertility is an important issue for patients with premature ovarian failure (POF). Although oocyte donation offers an alternative method to achieve a pregnancy, many patients seek to reproduce with their own gametes. We performed a literature search to evaluate the possibility of pregnancy following diagnosis, and the additional value of treatment strategies. We found 52 case reports, eight observational studies, nine uncontrolled studies and seven controlled trials. Due to a strong variability in study design, patient selection and mode of intervention, it was not possible to combine the data of the seven studies to perform a meta-analysis. None of the studies showed a statistically significant difference between both (or more) study groups. Due to a lack of incorporation of a placebo group, preference of any treatment over no treatment could not be established. Importantly, the collected data of observational, uncontrolled and controlled studies indicate that POF patients still have a 5-10% chance to conceive following diagnosis. Approximately 80% of the reported pregnancies resulted in the birth of a healthy child. There is no evidence that any treatment can enhance this pregnancy rate.