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The review of literature data on primary ovarian insufficiency (POI), its autoimmune aspect, determination of markers for early diagnosis of the disease, treatment options and implementation of reproductive plans was carried out. Autoimmune and genetic aspects of pathogenesis, markers of autoimmunity in ovarian tissue, which may be promising for early diagnosis in risk groups of patients with autoimmune pathology, were considered; information on the incidence of nosology in other autoimmune diseases, which will also allow to identify POI at early stages, was provided. This article provides information about a new direction in reproductive surgery – drug-free in vitro activation based on primordial follicle activation by modulating biological signaling pathways. This procedure may have a long-term perspective for realizing reproductive potential without the use of donor eggs. The literature search was performed in domestic (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The selection of sources was made within a limited period from 2016 to 2021. However, given the insufficient knowledge of the chosen topic, the selection of sources was dated from 2009. Key words: autoimmune oophoritis, hypergonadotropic hypogonadism, primary ovarian insufficiency, in vitro activation

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Life in a modern metropolis is not only an interesting and eventful life, but also a source of numerous features for human life: imperfect environmental conditions, dietary habits, sleep disturbances and circadian rhythms, changes in psychological status (stress, depression, aggression, apathy) and reproductive health problems, especially in women. As defined by the World Health Organization, reproductive health is a state of complete physical, mental and social well-being, and not simply the absence of disease in all areas related to the reproductive system, its functions and processes. Life in a big city for a woman of the reproductive period is often accompanied by a violation of the menstrual and ovulatory function, which can be attributed to the symptoms of the megalopolis syndrome. Since the 1980s, the frequency of menstrual irregularities has increased by more than 7 times. The doctor clinician, to whom a woman of the reproductive period with an irregular menstrual cycle first turns, should not only draw up a plan for examining a woman and exclude the presence of endocrine-gynecological disorders, but also collect a detailed history, including physical status (for example, calculating body mass index, analyzing fluctuations weight), dietary habits, sports history, medication intake, first assess the role of the psychosomatic factor. The correct pathogenetic approach in this situation will determine the correct therapeutic tactics for managing a woman.