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Primary ovarian insufficiency (POI) affects 1-3.7% of women before the age of 40. It is a public health problem. Despite an exhaustive assessment, approximately 60-70% of POI remain without an identified cause. Next-generation sequencing, in particular exome sequencing, has enabled the identification of several genes responsible for POI. To date, there are more than 80 POI causing genes with a very high genetic heterogeneity. These recent advances in genetics have shown that the meiosis and DNA repair gene family is a major family responsible for POI. The consequences are abnormal antenatal meiosis, with a very early alteration of the ovarian reserve whose impact varies according to the gene responsible. Indeed, genetics can predict a fertility prognosis. However, these genes are also tumor/cancer susceptibility genes and identifying the genetic cause will be an opportunity to prevent or treat these comorbidities. Epidemiological studies have indeed shown a link between infertility and reduced longevity. By identifying the molecular mechanism involved in POI, genetics allows personalized medicine to i) predict the impact of the molecular defect on the quality of the residual ovarian reserve, and can lead, if necessary, to early preservation of the preventive fertility in the family ii) identify the patients likely to develop comorbidities, and implement long-term treatment or prevention in a multidisciplinary team and to iii) identify new therapeutic targets that will lead to the development of innovative treatments in POI. This article focuses on the discovery of the involvement of genes in the double-stranded DNA repair pathway of the «Fanconi anemia pathway» in POI and on the impact of this discovery in the management of therapeutic burden and genetic counseling of patients. [ABSTRACT FROM AUTHOR]