Primary prevention
In general, POF can be neither predicted nor prevented. Avoiding risk factors, including smoking, hysterectomy, and uterine artery embolisation, may decrease the risk.[24] In patients requiring pelvic irradiation for malignancy, the risk of POF can be reduced by 60% to 100% by ovarian shielding or surgical transposition of the ovaries out of a field of radiation.[25] For patients requiring chemotherapy, the effectiveness of concurrent treatment with gonadotrophin-releasing hormone agonist to decrease ovarian follicle damage remains unclear, although a Cochrane review has shown evidence for efficacy, albeit with considerable heterogeneity of results from different studies.[26][27][28][29]
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Secondary prevention
Patients with genetic factors to the development of their POF may want to inform family members who could benefit from genetic counselling and/or testing for future reproductive planning.
Women who are to undergo potentially sterilising chemotherapy or radiotherapy can be offered embryo freezing or oocyte freezing. This should be discussed carefully with the lead oncologist and a reproductive medicine expert. Delay in starting treatment may reduce chances of survival in certain conditions.
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