Objective: To describe the etiology of hypergonadotropic amenorrhea (HA) and outline the subgroup of infertile women that might achieve pregnancy with their own egs despite premature ovarian failure. Methods: In this retrospective study we enrolled 70 women aged 32.5 ± 5.71 years. After a detailed history of the disease, measurements of follicle-stimulating hormone, estradiol, prolactin and thyroid-stimulating hormone levels, determination of the karyotype and fragile X premutation syndrome, and a quick ACTH test, estro-gen-progestin replacement therapy was introduced. Results: In 17 of the 70 women. HA was due to chromosomal abnormalities, in 16to extensive gynecologic surgery, in ten to oral contraceptive use, in four to chemo- and radiotherapy in 23 HA was idiopathic. After estrogen-progestin replacement therapy, three women with idiopathic HA conceived and delivered healthy babies. Conclusion: Estro-gen-progestin replacement therapy in pharmacological doses might be beneficial to women with idiopathic HA, having normal pro-lactin levels, adrenal and thyroid function, and a normal karyotype.