A Multicenter Observational Study on the Development and Health Effects of Premature Ovarian Insufficiency

Women with POI 1. Inclusion Criteria 1.1 Age at Diagnosis: Less than 40 years of age. 1.2 Diagnosis of POI: Met one of the following diagnostic criteria based on ESHRE guidelines: Spontaneous POI: Oligomenorrhea or amenorrhea for at least 4 months, combined with elevated FSH levels (\> 25 IU/L) on two occasions at least 4 weeks apart. Iatrogenic POI: Documented history of bilateral oophorectomy, or ovarian failure resulting from chemotherapy or radiotherapy. 1.3 Informed Consent: Willing to participate in the study, provide biological samples, and complete long-term follow-up assessments. 2. Exclusion Criteria 2.1 Current Pregnancy or Lactation: Women who were pregnant or breastfeeding at the time of enrollment. 2.2 Severe Systemic Conditions: Presence of severe somatic or psychiatric diseases (e.g., active malignancy not related to POI, severe heart/renal failure, or cognitive impairment) that would preclude adherence to the study protocol or long-term follow-up. Control 1. Inclusion Criteria: 1.1 Age: 18-50 years. 1.2 Menstrual History: Regular menstrual cycles (21-35 days) for the past 12 months. 1.3 Consent: Willingness to participate, provide biological samples, and provide written informed consent. 2. Exclusion Criteria: 2.1 Physiological Status: Pregnancy, breastfeeding, or clinical perimenopause/postmenopause. 2.2 Reproductive Disorders: History of PCOS, endometriosis, or other reproductive pathologies. 2.3 Iatrogenic \& Toxic Factors: Prior ovarian surgery (e.g., cystectomy), chemotherapy, or radiotherapy. 2.4 Systemic Diseases: History of endocrine (e.g., thyroid dysfunction), autoimmune, cardiovascular, liver, kidney, or hematological diseases, or malignancy. 2.5 Genetic \& Familial Background: First-degree relatives with POI or early menopause (\< 45 years). Family history of hereditary diseases. 2.6 Medication: Use of hormonal drugs or contraceptives within the last 6 months. Ovarian Surgery group 1. Inclusion Criteria: 1.1 Age: 18-60 years. 1.2 Patients with ovarian surgery: women scheduled to undergo ovarian surgery for gynecological disease. 1.3 Informed Consent: Willing to participate in the study, provide biological samples, and sign the informed consent. 2. Exclusion Criteria: 2.1 Reproductive Disorders: History of PCOS, endometriosis, or other reproductive pathologies. 2.2 Medication: Use of hormonal drugs or contraceptives within the last 6 months. 2.3 Genetic or chromosomal abnormalities: Turner syndrome, or other genetic disease. 2.4 Physiological Status: Pregnancy, breastfeeding, or seeking the help of assisted reproductive technology. 2.5 Severe systemic Diseases: History of endocrine (e.g., thyroid dysfunction), autoimmune, cardiovascular, liver, kidney, hematological diseases, malignancy, or cognitive impairment. Oophorectomy group 1. Inclusion Criteria: 1.1 Age: 45-65 years. 1.2 Patients with oophorectomy: women scheduled to undergo oophorectomy due to gynecological diseases and met criteria for being menopausal. 1.3 Menopausal status: at least 12 consecutive months of amenorrhea without other medical causes. 1.3 Informed Consent: Willing to participate in the study, provide biological samples, and sign the informed consent. 2. Exclusion Criteria: 2.1 Reproductive Disorders: History of PCOS, endometriosis, or other reproductive pathologies. 2.2 Medication: Use of hormonal drugs or contraceptives within the last 6 months. 2.3 Genetic or chromosomal abnormalities: Turner syndrome, or other genetic disease 2.4 Physiological Status: Pregnancy, breastfeeding, or seeking the help of assisted reproductive technology. 2.5 Severe systemic Diseases: History of endocrine (e.g., thyroid dysfunction), autoimmune, cardiovascular, liver, kidney, hematological diseases, malignancy, or cognitive impairment.