Approximately 14% of women with familial POFhave a premutation in the FMR1 gene, as comparedto 2% of women with isolated POF (42).For women with sporadic spontaneous POF, noanalysis of the cost/benefit or ethical, legal, or socialimplications of genetic counseling for FragileX syndrome is available; however, the AmericanCollege of Obstetrics and Gynecology (ACOG)recommended screening in these situations (33):. This evidence concerns the gene FMR1 and premature menopause.