Intrauterine Growth Retardation, Metaphyseal Dysplasia, Adrenal Hypoplasia Congenita, Genital Anomalies, and Immunodeficiency, also known as image-i syndrome, is related to intrauterine growth retardation, metaphyseal dysplasia, adrenal hypoplasia congenita, and genital anomalies and premature ovarian failure 7. An important gene associated with Intrauterine Growth Retardation, Metaphyseal Dysplasia, Adrenal Hypoplasia Congenita, Genital Anomalies, and Immunodeficiency is POLE (DNA Polymerase Epsilon, Catalytic Subunit). Affiliated tissues include nk cells and bone marrow, and related phenotypes are frontal bossing and microcephaly