My sister, who lives in India, has been told by an infertility specialist that she cannot become a mother because she is going through a premenopause phase. All the information that I have gathered about menopause says that it happens in women who are 45 to 60 years old. How is it possible that my sister, who is just 25, can be suffering from premenopause? The doctors also said that there is less than a 50 percent chance that she may be in the position to have a test-tube baby. Isn't there anything that could be done to solve this problem? According to what I have read, low levels of estrogen and/or progesterone that render a woman infertile can be corrected by medications like Premarin and Provera.

Sukanta

Ovarian function and egg quality are not always related to a woman's age. In fact, hormone testing may indicate diminished fertility up to 10 years before the onset of menopause. The most common blood test for these functions is the FSH level. This is typically obtained on or about the third day of the menstrual period, but an elevated FSH level at any time can be a cause of concern regarding future fertility. While the levels indicating concern vary from laboratory to laboratory (and different labs will find different FSH levels when testing the same sample), in most situations, levels much above 10miu/ml may be alarming. Other tests such as the estrogen level or inhibin B level on the third menstrual cycle day may provide more information. If these test results indicate diminished ovarian function, pregnancy is unlikely without using donor eggs with an in vitro (IVF) procedure.

Testing for immune abnormalities and chromosomal defects may help identify a cause. While immune abnormalities may be reversed with treatment, if the ovarian dysfunction is related to a chromosomal problem, treatment is not effective. Other causes for diminished ovarian reserve -- such as surgical injury, radiation drug toxicity (cancer treatment) or infection -- must also be considered.