Pregnancy with Premature Ovarian Insufficiency (POI): Realistic Chances, Spontaneous Ovulation, and Donor Egg Options

Understanding What POI Really Means

Many women are told that premature ovarian insufficiency (POI) means their ovaries have stopped working, but that’s not the full story.

In conventional medicine, POI is defined as ovarian failure before age 40, marked by high FSH, low estradiol, and very low AMH.

Treatment usually centers on hormone replacement therapy (HRT) or donor eggs for conception.

The functional fertility perspective looks deeper. Ovarian function is reduced but not gone; ovulation can still occur intermittently, and cycles may “flicker” on and off.

POI vs Menopause

• Menopause: ovarian activity ends permanently.

• POI: ovarian function is unpredictable and fluctuating; eggs may still mature and release.

Contributing Factors Often Overlooked

• Autoimmune activity: thyroid antibodies, ANA, or celiac markers.

• Gut dysfunction: low sIgA, dysbiosis, and gluten reactivity.

• Environmental toxins: mold, plastics, pesticides.

• Chronic stress and HPA-axis dysregulation.

Message: POI isn’t simply “bad luck.” It often signals a broader whole-body imbalance. Fertility is the messenger, not the problem.

Realistic Chances of Pregnancy with POI

Studies estimate that 5–10 % of women with POI conceive naturally [Cleveland Clinic 2024】.

While that percentage may seem small, it shows that spontaneous ovulation can still occur.

When Chances Are Higher

• Age < 35

• Irregular cycles (not complete amenorrhea)

• Detectable mid-cycle estradiol rise

When Chances Are Lower

• Long-term absence of periods

• Persistently high FSH with no fluctuation

• Multiple untreated autoimmune conditions

Functional fertility takeaway:

“Low is not zero.” Supporting immune balance, reducing inflammation, and improving mitochondrial function can make those rare ovulations count.

Spontaneous Ovulation: How to Catch It

Many women with POI are told ovulation is impossible, yet research confirms intermittent ovarian activity is common.

The challenge is timing, catching those rare fertile windows.

Tracking Strategies

1. Mira Fertility Analyzer – measures LH, estrogen, and progesterone metabolites.

2. PDG tests (Proov Confirm, Inito) – confirm ovulation 7 days after the LH surge.

3. Cervical mucus – clear, stretchy discharge signals rising estrogen.

4. Basal Body Temperature – sustained rise confirms ovulation has occurred.

5. Mid-cycle labs – estradiol, LH, and day-21 progesterone confirm activity.

Functional Tips

• Manage stress, optimize thyroid, and improve sleep to stabilize ovulation signals.

• Use multiple tools (LH + PDG + symptoms) for accurate tracking; false surges are common in POI.

Practical tip:

“Think of ovulation tracking as building a net; the more tools you use, the better your chances of catching a rare event. However, it’s important to recognize that tracking can become overwhelming or triggering for some. That’s why we often encourage clients to first focus on establishing a strong foundation with nutrition, sleep, and stress regulation before adding tracking tools back in.”

Hormone Therapy and Bioidenticals

HRT protects bones, brain, and cardiovascular health, but in functional fertility, hormone support is personalized and short-term.

• When to use: symptomatic low progesterone, short luteal phase, night sweats, thin uterine lining.

• Always combined with nutrition, gut healing, and lifestyle support.

• Avoid in: hormone-sensitive cancers, clotting disorders, and uncontrolled autoimmune conditions.

Hormone or Ovarian Support Protocols

• Low-dose estrogen replacement, DHEA supplementation, or natural progesterone (guided by a practitioner) can support bone, heart, and reproductive health during POI

 

• We do not recommend synthetic hormones, as these can come with unwanted side effects and may not address the underlying imbalances affecting ovulation and fertility.

 

Message Bioidential hormones can play a supportive role in pregnancy preparation, but they're not a standalone fix.  Optimizing lifestyle, nutrient status, and inflammation control always comes first.

Functional Fertility Foundations for POI

POI reflects multiple system imbalances. Addressing these areas supports egg quality, hormonal balance, and implantation readiness.

1. Gut Health

• Low sIgA = weakened mucosal immunity

• Gluten sensitivity linked to miscarriage and thyroid autoimmunity

• GI-MAP often reveals dysbiosis or infection

Interventions:
Gluten-free diet (if reactive), targeted probiotics, zinc, glutamine, and anti-inflammatory foods.

2. Immune Balance

Up to 30 % of women with POI have autoimmune markers. Vitamin D, selenium, and omega-3s help regulate immune tolerance.

3. Toxin Reduction

• Mold/mycotoxins: Ochratoxin A and Mycophenolic acid damage follicles.

• Pesticides & plastics: accelerate ovarian aging.

Support gentle detox through cruciferous vegetables, NAC, hydration, and binders when supervised.

4. Nutrients & Mitochondria

Eggs are energy-dependent cells. Low ferritin, B12, folate, and magnesium impair mitochondrial function.

Supplementation with CoQ10 (ubiquinol), omega-3s, and antioxidants enhances energy and egg integrity.

5. Nervous System Regulation

Chronic stress can silence ovulation. Restoring vagal tone through acupuncture, breathwork, and somatic therapies reactivates reproductive signaling.

IVF with Your Own Eggs: When It Makes Sense

While many clinics discourage IVF in POI, it can work for select women.

Candidates Who May Benefit

• Detectable AMH (even very low)

• Visible antral follicle on ultrasound

• Some spontaneous cycles

• Age < 38–40

Preparation Matters

Before starting IVF, address:

• Elevated hsCRP or autoimmune activity

• Thyroid and prolactin optimization

• Nutrient repletion (vitamin D, B12, folate, iron, omega-3)

• Mitochondrial support and detox pathways

Message: IVF success with POI isn’t guaranteed, but with functional preparation, every egg retrieved has higher potential.

Donor Egg Options

Donor eggs bypass the ovarian limitation, but preparation still matters.

Why Donor Eggs Work

• The uterus is usually healthy.

• Egg quality, not womb receptivity, is the barrier.

Types of Donor Cycles

• Frozen donor eggs: faster and lower-cost.

• Fresh donor eggs: higher embryo yield and success per transfer.

• Embryo donation: viable in select clinics.

Functional Support for Donor Egg Success

Even with donor eggs, thyroid, vitamin D, immune balance, and microbiome health are essential for implantation and pregnancy stability.

Emotional Readiness

Choosing donor eggs can bring grief and uncertainty. Most women find peace once pregnant, but emotional preparation and partner communication are key parts of this journey.

Decision Pathway

1. Optimize health first - gut, immune, thyroid, nutrients, toxins, and stress.

2. Track ovulation - catch spontaneous activity.

3. Consider IVF - if ovarian function remains.

4. Explore donor eggs - when needed, after functional preparation.

Case Study: “Amanda’s Journey with POI”

Amanda was diagnosed with POI at 37 and was told her only option was donor eggs.
Her AMH was < 0.08 ng/mL.

Through the Fab Fertile Method,  including gut repair, thyroid support, and immune modulation, she began having occasional ovulatory cycles and conceived naturally and delivered a healthy baby girl.

Her story illustrates that POI does not always mean the end of natural fertility. It’s a signal to explore the deeper imbalances affecting ovarian function.  Listen to her story here.

Amanda’s results are specific to her experience; individual outcomes vary and are not guaranteed.

Next Steps in Your Fertility Journey

Subscribe to Get Pregnant Naturally for evidence-based guidance on functional fertility, and share this episode with anyone on their fertility journey.

Not sure where to start? Download our most popular guide:  Ultimate Guide to Getting Pregnant This Year If You Have Low AMH/High FSH it breaks everything down step by step to help you understand your options and take action

For personalized support to improve pregnancy success, book a call here.

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TIMESTAMPS

00:00  The truth about POI and pregnancy

POI isn’t always the end of the road. Learn how spontaneous ovulation and functional fertility preparation can open new possibilities even after a diagnosis of premature ovarian insufficiency.

01:00 What POI really means (and how it differs from early menopause)

Conventional vs functional views of ovarian function: why “flickering” ovarian activity matters for pregnancy potential.

02:30 Underlying imbalances behind POI

How autoimmune issues, gut dysfunction, toxins, and stress affect ovarian function and fertility outcomes.

04:00 Realistic chances of pregnancy with POI

Research-backed data showing 5–10% of women with POI conceive naturally, plus factors that improve success rates.

06:00 Spontaneous ovulation and how to catch it

Tracking methods like Mira, Inito, and PDG tests can help you detect rare ovulations and time intercourse or IVF cycles effectively.

08:00 Managing stress and nervous system regulation

Why chronic stress and HPA-axis dysfunction shut down ovulation, and how the nervous system work restores reproductive signaling.

10:00 Gut, immune, and environmental testing for POI

Why stool, food sensitivity, and mycotoxin testing matter for egg quality, implantation, and autoimmune balance.

12:00 Nutrients and mitochondrial support for egg quality

How CoQ10, magnesium, selenium, vitamin D, and omega-3s support ovarian function and improve outcomes.

15:00 IVF with your own eggs and donor egg options

When IVF may still work for women with POI, and how to prepare your body functionally before considering donor eggs.

18:00 Hope and next steps for POI and fertility

Why POI doesn’t mean no chance from spontaneous ovulation to IVF and donor eggs, discover how health-first strategies improve success.

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TRANSCRIPTION

[00:00:00] Premature ovarian insufficiency or POI is often described as the end of the road. You're told your ovarian reserve is gone. Your only option is donor eggs and that natural pregnancy is off the table, but that is not the full story. Some women with POI still ovulate spontaneously. Some conceive naturally and many achieve pregnancy with the right preparation with assisted reproduction.

Today we're going to look at some realistic chances of pregnancy with POI, how to detect spontaneous ovulation, where donor eggs fit in, all of this is through a functional fertility lens. Let's go.

Welcome back. I'm Sarah Clark, founder of Fab Fertile. For over a decade, my team and I have helped hundreds of couples improve their chances of pregnancy success, whether naturally or through IVF. We specialize in supporting those with low AMH, high FSH, diminished ovarian reserve, premature ovarian sufficiency, and recurrent pregnancy loss through functional lab testing and personalized fertility strategies.

This episode is for you as if you've been diagnosed with POI, premature ovarian [00:01:00] sufficiency, and you're told your only option is donor eggs. You're wondering if spontaneous ovulation or natural pregnancy is still possible low AMH or high FSH, and you want to understand how functional fertility strategies can improve your chances, whether trying naturally with IVF or with donor eggs.

Thanks so much for listening. I'm so thankful that you're here. Make sure you hit subscribe or follow, and if you know someone else who's on the fertility journey, please share this podcast with them.

We're talking about pregnancy success and the chances of pregnancy with premature ovarian insufficiency. So from the conventional standpoint, POI, so premature ovarian insufficiency, the loss of the function of the ovaries before the age of 40 is typically characterized with high FSH and low estradiol,

Very low AMH. Treatment is usually focused more on hormone replacement and donor egg. The functional fertility view. If you've listened to some of my podcasts here, ovarian function is reduced but not completely absent, and ovulation may still occur intermittently. Important distinction.

So menopause is the ovarian function is completely [00:02:00] ending. Where premature ovarian insufficiency is, the ovulation is unpredictable, it's fluctuating and sometimes flickering. Contributing factors that are often overlooked. We can't just look at the diagnosis and the AMH and the FSH.

We have got to look at the rest of our health. Even if you feel fine, because if you were fine, we wouldn't be dealing with this diagnosis, we got to look to see what's going on. Just recorded a podcast episode about autoimmune activities. So definitely listen to that one. Is there a thyroid or celiac or maybe you just got that positive, ANA anti-nuclear antibodies, not an actual full-blown autoimmune disease, but something is inflamed in there and potentially, predisposing you to an autoimmune issue.

So is there autoimmune activity? Do you have gut issues? You could have gluten reactivity, you've got infections in there, you've got low immune systems. You get every cold and flu. So the body is really under attack. Is there environmental toxins you're exposed to? Mold or plastics or pesticides? Yes. We're all [00:03:00] exposed to those.

We don't go chasing down a mold protocol, but sometimes, you know what has tipped it the wrong way and then we need to build the strong foundation. Addressing infections, reducing inflammation, working on the stress piece, and that's the next one. Chronic stress. So that HPA axis dysfunction is the adrenals that impact the thyroid impacts the AMH and the FSH and the follicle count.

It's not just about the POI diagnosis is often a systemic imbalance with fertility. So deprioritizing your reproductive health because you've got something else going on with your health. And so studies estimate five to 10% of women with POI conceived naturally.

This is small, but meaningful. It shows the ovaries sometimes will still release eggs. I do believe that once we start to address the underlying issues with this, that would be higher. We're just going from an old conventional approach where they tell you, you just go on HRT. And just do donor eggs.

And then sometimes people just conceive because they have [00:04:00] spontaneous ovulation. So we need to really be our own advocate here. But I'm never going to sugarcoat something. This is a tough diagnosis, but we can't ignore the health. Because it'll catch up with you. I was diagnosed with POI at 28.

I did go on to have both my kids with donor eggs. My daughter's 23, my son's 21, and my health took a nose dive. I had chronic UTIs. I had chronic sinusitis. I had chronic yeast infections, took a whole boatload of antibiotics, destroyed my gut health, and then years later figured this out and worked to reduce inflammation from food, from gut infections.

And all of this for me was chronic stress, which I do believe tilted things over. I don't have Celiac, but I think I had a gluten sensitivity. So non-celiac gluten sensitivity early on in life had these big circles under my eyes and a lot of gut issues. Then it just went into this.

And so we specialize helping people with low AMH, diminished ovarian reserve, recurrent pregnancy loss, implantation failure embryos that are abnormal. And then we start to work on our health and people go on to conceive. So not every single [00:05:00] person goes on to conceive. So we need to be open to what's going to happen here.

I don't want to sugarcoat something and give someone false hope, but we've got to go in looking at our health and so the chances are higher when you're under 35. We've helped people with, very low numbers at 44. The AMH of 0.02 ng/mL. Go on to get pregnant naturally. People in their forties bringing back their period.

I'm just thinking, Amanda, at 38 with POI going on to conceive naturally. But obviously the younger you are the higher the chances. So women under 35 intermittent or irregular cycles versus complete amenorrhea. Sometimes people are still having their cycle, but it's intermittent.

There's a better chance, but we've had people with no cycle, restore it. And then detectable estradiol. So it's going to be rising mid cycle. So when it's lower, if no period for years, then that's a little more difficult. Persistent high FSH, no fluctuation.

It should fluctuate. It fluctuates each cycle. And you got a whole bunch of autoimmune issues. Autoimmune issues are a signal. A lot of times we'll follow the conventional approach taking medication or steroids, [00:06:00] and when we actually address those that we can go on to conceive. Helped many people with Hashimoto's. Ulcerative colitis celiac, go on to conceive.

Type I diabetes. We need to work at our health. Functional fertility side of things is low, is not zero, and we've got to calm down the inflammation, balance the immune system, improve the mitochondria, so the powerhouse of the cells, and then you can increase the quality during those rare ovulations.

So spontaneous ovulation. Women with POI are told that ovulation is impossible, but research shows intermittent ovarian activity is common. Ovaries can wake up and release an egg unexpectedly. So even if the cycles are irregular, it can still happen.

So we use fertility trackers. Looking at your basal body temperature. We like Mira or the Inito can look at your estrogen and your progesterone metabolites and more reliable than those LH strips. But looking at the cervical mucus, looking at the basal body temperature so it [00:07:00] shifts, will confirm ovulation.

And then we want watery or egg white consistency. We've had people that have had no cervical mucus and they're having that come back, so we need to. If your cycle is irregular, we need to determine when to bring in the fertility tracking. It can be triggering and stressful.

So if you feel hypervigilant or very sort of a perfectionist kind of piece on that, we need to weigh being triggered versus looking at it from helpful. So the functional side of things, we got to work on your stress. That's the elephant in the room. And it's a type A controlling, perfectionist, go-getter woman that we typically work with.

She's probably done quite well in her career. She might be even deciding to do IVF. Maybe you've done IVF. It hasn't worked. We're working full-time, many times, more than 50 hours. And also we're maybe in the process or have done a graduate study. So all of this is a lot of stress on our bodies.

Sometimes we see the hormones, the adrenals just flatlined. We got to work on our sleep. There could be a whole host of reasons [00:08:00] why your sleep is off from magnesium deficiency to sluggish liver to blood sugar spikes to adrenaline spikes in the morning. All of that is key. If your sleep is off, that's impacting your health and your fertility, and also looking at the thyroid.

Done many episodes on thyroid. This is a huge clue. We see adrenals impact the thyroid impacts the AMH the FSH the follicle count. If you've got POI, you wanna maximize natural chances. If you're ovulating, we want to be able to catch that ovulation, obviously and help maximize it and improve egg quality.

You can't test for egg quality, but everything you do from your health is going to improve it. We may want to bring in the bioidentical hormones. Typically if there's symptoms, you've got short luteal phase, you've got low progesterone, so you've got spotting, thin lining, hot flashes.

You may want to bring that in. We always pair it with a diet and lifestyle change. It's not a replacement and it's very short term. It's individualized. It's not for people that have hormone sensitive cancers, clotting disorders, or uncontrolled autoimmune disease. We always want to make sure the foundation of your body.

[00:09:00] Is strong before we just bring those in, but we're not against them. We definitely don't want to do synthetic hormones, so it is very individualized. We have a whole checklist on this and part of our program to see who would benefit. We have a doctor, as part of our team.

He's our medical case reviewer. He is not your doctor, but he's there to review cases and advise us to help improve pregnancy outcomes. He's an OB GYN with a functional medicine background. We've got to look to see what's driving the POI symptoms. So when we do that, this can improve egg quality, regulate your cycles, and prepare for pregnancy.

either naturally, or with IVF. If you've got gut issues, so you've got a low secretory IGA, which we see in the stool test, it can be a weakened gut immune barrier. So more infections come in. We see this all the time elevated anti-gliadin antibody, so we can equal gluten sensitivity linked to a higher miscarriage risk and autoimmune thyroid issues.

I see people that have Hashimoto's and then their anti gliadin is off the chart. [00:10:00] Even if they tell me they've been going gluten free or maybe no one's even told them to go gluten free. Then some of the cross reactors with that. So we need to be very open to looking at the drivers of inflammation from a dietary perspective here.

And it's not about taking those foods out forever. Typically. Gluten, maybe, yes. But most of the foods you should be able to bring back in. You don't want to be on this very restrictive diet forever. That's not helpful. Looking at the gut health for infections and then doing that elimination diet.

Send me a message at hello@fatfertile.ca, subject line 10 DAY and I'll send you the elimination diet, tells you exactly how to take out the inflammatory foods, how to reintroduce them. Then we need to address the infections when you do gut healing with probiotics, specific strains based on what we're finding in your stool test.

After the gut microbiome, we do vaginal microbiome testing as well. So maybe there's inflammation there, and that's why things aren't working. Up to 30% of women with POI have autoimmune markers, so thyroid antibodies or ANA.

Autoimmunity [00:11:00] can impact ovulation implantation just in a whole episode on POI and autoimmune issues. So really dig into that one. Intervention so we can look at bringing in vitamin D. We see a lot of people with low vitamin D and low AMH and high FSH, POI bringing in selenium omega threes to support the immune system.

Looking at environmental toxins. Maybe you have some mycotoxins that are impacting ovarian tissue, so mold or pesticide residues can accelerate ovarian aging. So we don't just go in on a big mold protocol, we need to look at the whole body, and then we can do some additional tests. But we start with food, stool, and genetics.

We want to bring in hormones too. We can bring that in such as DUTCH testing, but we've got to be careful about just doing one test and then not even doing a proper protocol. This is multifactorial. We do the testing alongside the nervous system regulation because without that piece, if you still feel panicked, you've got that AMH circulating around in your [00:12:00] subconscious, and we just think there's no hope that keeps us on high alert, and maybe we're feeling hypervigilant and our body can't relax and can't, it's not about you.

Hey, relax, you'll get pregnant, the elephant in the room is the stress and we can't ignore that piece. And so we gotta reduce our exposure. We can use binders. You can't do this by yourself. You gotta get someone that's specializing in it and not a generalized practitioner. You need someone who specializes in fertility.

Either you decide to work with us send me a message at hello@fabfertile.ca. Subject line FERTILE. You can give options to help. If you decide to work with someone else, just make sure they specialize in fertility and POI and they're not just oh, what's that? Oh wait just do my general protocol and you spend a whole bunch of money and wonder why it doesn't work.

The nutrient side of things. Looking at your ferritin. We see this low. We like that between 80 to 100. For IVF, we see people's B12 being either low, we like that to 800 to 900 or falsely high. We see people's folate being low magnesium, a lot of us are deficient magnesium, we wanna take magnesium [00:13:00] glycinate, so zinc.

In POI those those nutrients are suboptimal. We want to bring in the coq 10. I think a lot of people are already taking the ubiquinol to improve the mitochondria, the energy and the eggs. And then antioxidants can counteract the oxidative stress that can damage fo follicles. Nervous system dysregulation.

So chronic stress and trauma. We do see this a lot with people. Even the diagnosis itself with POI can be traumatic. It can dysregulate the HPA axis and the ovulation can shut down. We can restore this through breath work, through acupuncture, through meditation, somatic practices to support reproductive signaling.

We have a mindset coaching here to really help you regulate your nervous system. It's not just one thing it's really seeing how, in times of stress, what do you do? You're probably going into research like me. That's why you're listening to this podcast. And that can be your superpower and that's great, but we need to give that over to someone else.

because if we just DIY this take on all of ourself doesn't give the body time to reset [00:14:00] itself. POI isn't just an ovarian problem. It's a whole body imbalance, gut, immune toxin, stress, and we work on those. We're not just supporting fertility, it's overall health.

And these shifts can improve the chances of IVF or even if we decide donor eggs to improve success with that. For conventional perspective, IVF is usually discouraged in POI because the yield is low. But some women do conceive of their own eggs, especially if the ovarian activity is still detectable when it's reasonable to try is AMH is detectable.

Even very low. Ultrasound shows, at least one antral follicle. You've got intermittent periods with ovulation and you're younger, under 38 to 40 that hasn't had prolonged amenorrhea. But your retrievals may yield, one to three eggs. The high FSH may limit your response to simulation.

And then not all cycles will result in retrieval because of the ovaries may be inactive. So that's the conventional side of things, functional side of things. We want to do a whole bunch of [00:15:00] stuff before we go to improve the chances of IVF. So to reduce inflammation.

Looking at your high sensitivity C-reactive protein. We want it under one. I see it elevated all the time. Gluten. We see that theme of non-celiac gluten sensitivity. Taking out gluten and dairy for 60 to 90 days, doing the food sensitivity test. because maybe you're intolerant to lettuce.

Or some of your other favorite foods, and we can be able to reduce inflammation in a targeted manner. Optimize thyroid. We sometimes see prolactin elevated. Addressing nutrient deficiencies, the D the iron. We see a lot of people that are anemic. The low vitamin B12, the folate. We want to make sure it's methylfolate that we're taking your omega threes to help with reducing inflammation.

Supporting your mitochondria. So the powerhouse of the cell with some antioxidants and addressing gut infections and toxins that are going to impair egg quality. IVF with your own eggs is not a guarantee, but for someone with a POI, it can work. So the key is always [00:16:00] preparing your body first.

Otherwise, the emotional financial costs may outweigh the benefit so that prep beforehand can make each egg count. Maybe you do need to go to donor eggs, right? I just said that kind of very flippantly, but if you decide to go to donor eggs that's a very personal decision, right?

But we still have to work on your health, you got to make sure the uterus is healthy. The donor eggs are going to bypass the ovarian reserve and the egg quality issues. You can do frozen or fresh or embryo donation.

They've got a higher success rate, 50% per transfer. It's among the highest and the fertility side of things. And that's why your clinic is probably recommending it because they know that with POI, there's a low chance. The younger donor age is the main driver of outcomes.

So you can have a donor that's 28 or 29 and have healthier eggs and a better outcome. We still need to make sure the host. YOU is in the best shape. Otherwise, it may reject the embryo and it may not implant. So we still have to work [00:17:00] on our health. We've had many people that have decided to go to donor eggs and it actually works.

Working on the thyroid, the vitamin D, but that's low immune balance to really support implantation. Addressing inflammation and if you've got autoimmune issues, can still cause miscarriage, even with donor eggs working on the gut health and yet your vaginal microbiome. So you've got infections in the vaginal microbiome.

You're transferring ureaplasma back and forth with each other. Check out that episode . That can be why things aren't working. There's an emotional readiness with this. We got to grieve the loss of a genetic connection. That is real. There's couples counseling and counseling beforehand.

Many women feel peace once they're pregnant with donor eggs. The decision does require processing. Obviously I had both my kids with donor eggs and back then, 25 years ago, no one was talking about any of this at all. Now there's lots of support I know if someone hasn't been through it, they don't understand.

And we worry we're not going to bond with our children, that we won't look like our children, that there's going to be all these issues. Really, for me, there was none of that. [00:18:00] People say I look like my daughter. I don't see it. But we have the same mannerisms and my son, so I'm six foot and my husband's five eight, so it's with my husband's sperm.

He's about 5 ft 10. He is always like measuring me. I'm like, yep, I'm still taller than you. Each kid is different as who wants to know their genetic background, I have that from the paternal and the maternal grandparents.

Definitely listen to my story there with POI, I share more about that journey 'because it's a very personal journey and you need to decide if that's right for you. But we need to have an open mind and open to what's possible. So it's not a failure doing donor eggs, it's simply another path to motherhood.

So with the functional approach and being able to work on your health. Success rates are higher, pregnancy outcomes are healthier, and you're going to enter parenthood in your best state. Always working on your health first, your gut, your immune system, thyroid, nutrients, toxin stress track for spontaneous ovulation.

For natural success. We need to be careful here. We're going to be doing some protocols. The typical protocol is three to four months, so some of the supplements are contraindicated [00:19:00] for pregnancy. So you really want to reduce the risk of pregnancy loss. So even though there can be spontaneous ovulation here, we need to make sure you're not going to have a loss.

Sometimes things fire up and the body's not ready to sustain pregnancy. So we need to really look at this on an individual basis and make informed decisions based on our biomarkers when it's time to try. If we decide to do IVF, then we can look at that and then potentially we need to go to donor eggs.

POI does not mean there's no chance of pregnancy. So some women do conceive naturally the spontaneous ovulation. I do believe as more people start to understand the functional side of things in health, that will improve because right now, POI. Sorry, there's nothing you can do. But as we understand what's driving it, then we can im prove pregnancy outcomes and prepare your body, balance your gut health, calm the immune system, support nutrients.

Work on nervous system dysregulation. This is not promising miracles, although we do see miracles. All the time when people were told donor eggs is their only option, they go on to conceive, [00:20:00] but I never want to sugarcoat anything. Your health is the first focus. And when we do that, we can then make informed decisions on our next path forward.

So if you want to get my eyes on your specific situation, send me a message at hello@fabfertile.ca. Subject line FERTILE. We can give options to help. Take care.

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How to Get Started With Functional Fertility Support

Book your call here to get your personalized plan and options to help improve pregnancy success either naturally or with IVF treatment. 

Check out our Fab Fertile functional fertility program here and learn how to improve AMH levels naturally.  We work with couples that have low AMH, high FSH, diminished ovarian reserve, premature ovarian insufficiency, and recurrent pregnancy loss.

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FAQ: Common Questions About POI and Pregnancy

Q: Can I still ovulate with POI?

Yes. Many individuals with POI have intermittent ovulation. Supporting the hormonal and metabolic environment increases those chances.

Q: Does AMH predict pregnancy potential in POI?

Not always. AMH reflects follicle quantity, not quality or function. Ovulation and conception have occurred even at “undetectable” AMH levels.

Q: What tests should I run?

A comprehensive approach includes:

• FSH, LH, Estradiol, AMH

• Thyroid panel (TSH, Free T3, Free T4, antibodies)

• Adrenal rhythm (DUTCH test)

• GI-MAP or microbiome test

• Autoimmune screen (ANA, hsCRP)

Q: Is donor egg the only option?

No. While donor eggs increase IVF success rates, natural conception and improved ovarian function are possible for some, especially with functional optimization.

Q: How long should I work on this before considering IVF?

Most of our clients at Fab Fertile follow a 4–6-month preconception protocol before retesting hormones or proceeding with IVF, and our average pregnancy success, naturally or with IVF, occurs within 12–18 months; however, individual results vary and cannot be guaranteed.

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Key Takeaways

• POI doesn’t always mean early menopause. Ovulation can still happen spontaneously.

• Up to 10% of people with Premature Ovarian Insufficiency conceive naturally.

• A functional fertility lens looks at inflammation, autoimmunity, gut health, thyroid/adrenal balance, and mitochondrial function.

• Both natural and assisted options exist, and improving your internal environment can enhance either path.

• Tracking, testing, and personalization are essential; what works depends on your unique biology.

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RESOURCES

📩 Get your free 10-day elimination diet plan! Email hello@fabfertile.ca with the subject line 10 DAY to receive your guide and take the first step toward reconnecting with your fertility.

Get Pregnant Naturally with Low AMH, Diminished Ovarian Reserve or POF: (Sarah's Story) 

Is Your Thyroid Impacting Egg Health? The Hidden Connection to Low AMH, DOR & Fertility Success

Autoimmune Roadblocks to IVF: How ANA Affects Fertility

Is Your Thyroid Impacting Egg Health? The Hidden Connection to Low AMH, DOR & Fertility Success

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