BACKGROUND: Women with premature ovarian failure often receive hormonal replacement therapy as part of the management strategy. However, it is very unusual for patients to become pregnant while on hormonal therapy. CASE: A 33-year-old woman with a history of infertility and secondary amenorrhea was diagnosed with premature ovarian failure. Part of her infertility workup included laparoscopy-hysteroscopy, a dye test with methylene blue, and endometrial and bilateral ovarian biopsy. Two months after completion of this procedure, the patient underwent sonography, which showed an intrauterine pregnancy at 14 weeks' gestation. The pregnancy continued to term, and a healthy infant was born. CONCLUSION: In most instances the etiology of premature ovarian failure is unknown. In rare cases this condition undergoes spontaneous, reversible remission. One interesting observation in our patient is that despite the performance of invasive diagnostic tests, there were minimal detrimental effects on the patient's pregnancy and infant. This case illustrates that the remote possibility of a spontaneous pregnancy in women with premature ovarian failure should always be considered, and invasive diagnostic procedures should be performed when an intrauterine pregnancy is ruled out with certainty.