There have been previously published several anecdotal cases of women in apparent or imminent ovarian failure who subse­quently ovulated and became pregnant. Many of these women had been treated with estrogen. A series of cases were reported where women with hypergonadotropic hypogonadism who failed to stimulate despite gonadotropin therapy were able to ovulate when treated with pharmacologic doses of estrogen alone or in combination with human menopausal gonadotropins. Presented herein is a case of a woman with imminent ovarian failure with tubal disease who failed to stimulate with gonadotropins alone but was suc­cessful with estrogen and gonadotropins. We believe this is the first successful case of hypergonadotropic hypogonadism to conceive by in vitro fertilization.