primary ovarian failure ( pof ) is a syndrome composed of amenorrhea , estrogen deficiency and follicular stimulating hormone ( fsh ) of menopausal ranges in young women . in this article a 29-year old woman with a history of primary amenorrhea attended hospital with full term pregnancy . she had experienced a few episodes of withdrawal bleeding on hormonal treatment initially and she had conceived spontaneously . this case was presented to emphasize the real chances of spontaneous conceptions due to intermittent and unpredictable ovarian function in patients with poi . nevertheless , egg donation is still considered the best option for infertility in such women . fuller albright first described a condition he termed primary ovarian insufficiency ( poi ) in 1942 when he reported a syndrome of amenorrhea , estrogen deficiency and menopausal follicular stimulating hormone ( fsh ) levels in young women ( 1 ) . herein , we report such a case that had primary amenorrhea and presented with full term pregnancy . a 29-year - old woman attended antenatal out - patient department of north eastern indira gandhi regional institute of health and medical sciences ( neigrihms ) , shillong , meghalaya , india with full term pregnancy in october 2009 . she gave a very interesting history of primary amenorrhea with a few episodes of withdrawal bleeding upon hormonal treatment in the past . for the past 3  4 years she had not been receiving any treatment and had remained amenorrhoeic . after 4 years of marriage , she went to a local doctor for nausea and vomiting and , to her surprise , her urine pregnancy test was positive . her expected date of delivery ( edd ) was calculated from the first trimester ultrasound , which confirmed the gestational maturity . on examination , , uterus was found to be in the form of a full - term pregnancy . the fetus was in cephalic presentation and fetal heart rate ( fhr ) was 136 beats per minute and regular . per vaginal examination revealed a closed internal os with soft , short and central cervix . caesarean section was performed on maternal request and a healthy male baby weighing 2.5 kg was delivered . primary ovarian insufficiency has varied manifestations of amenorrhea , oligomenorrhea or dysfunctional uterine bleeding . overall , approximately 10% of women with poi present with primary amenorrhea ( 2 , 3 ) . a similar case of spontaneous pregnancy has been reported in a 27-year old woman with hypergonadotropic ovarian failure ( 4 ) . we suspected her to be a case of primary ovarian insufficiency on the basis of history alone and in the absence of any laboratory test of increased fsh , since we admitted her for the first time in full term pregnancy . this case was reported to emphasize the real chances for a spontaneous conception because of the intermittent and unpredictable ovarian function in these patients . primary ovarian insufficiency occurs in only 1% of women it can still result in spontaneous pregnancy in 5 - 10% of the cases . women with poi should be educated on the nature of the disease and the current research efforts . it is important to be aware of the condition and the options for future treatment .