Effects of autologous stem cell therapy for fertility enhancement among women with premature ovarian insufficiency

Jesmine Banu; Nishat Jahan; Shaheen A. Anwary; Mostafa Tarique; Itrat Aziz; Nastaran Laskar; M. Rifat Hasan; Chowdhury F. Alamgir; Maliha Darmini

This study looked at whether a procedure called autologous stem cell ovarian transplant (ASCOT) can improve ovarian function in women with premature ovarian insufficiency (POI). POI means the ovaries stop working normally before age 40, which reduces fertility and affects hormones. ASCOT uses a woman’s own stem cells, placed into her ovaries, with the hope of restoring some egg‑making activity.

Key findings: after treatment some women showed measurable improvements in ovarian reserve tests — higher anti‑Müllerian hormone (AMH) and more antral follicles (AFC) — although overall pregnancy was rare (4% after three treatment cycles). Results suggest ASCOT may improve ovarian signals linked to fertility for some patients, but it remains experimental.

Premature ovarian insufficiency (POI) causes reduced egg supply and changes in hormones like AMH and follicle‑stimulating hormone (FSH). Currently, standard options for women who want children include donor eggs or embryos. Researchers are studying regenerative approaches such as injecting a patient’s own stem cells into the ovary (autologous stem cell therapy) to try to reactivate or support remaining follicles.

Why this matters for stem cell banking: Autologous approaches use a person’s own cells, so having stored autologous stem cell sources (for example, cord blood, cord tissue, or banked adult stem cells) could expand future treatment options for fertility preservation and age‑related ovarian decline.

• Study type: prospective observational study.
• Participants: 50 women diagnosed with POI.
• How POI was defined in the study: very low AMH (<0.5 ng/dl), high FSH (>25 ng/ml), and/or low antral follicle count (AFC <3 in each ovary).
• Intervention: autologous stem cell ovarian transplant (ASCOT) — the woman’s own stem cells were placed into her ovaries (the article reports outcomes after up to three treatment cycles).
• Main measurements: AMH (a blood marker that reflects ovarian reserve), FSH (a hormone that rises when the ovaries are underactive), and AFC (number of small visible follicles on ultrasound).

• After the first post‑treatment cycle:
• Mean AMH increased by 0.48 ± 0.306 (not statistically significant overall).
• Mean FSH changed by +2.73 ± 3.98 (not a consistent improvement in this early assessment).
• Mean AFC decreased by 1.33 ± 0.625 (a surprising early drop).

• After the second cycle:
• AMH increased by 0.110 ± 0.051 compared with baseline.
• AFC increased notably by 4.63 ± 1.49.
• FSH decreased by 7.4 ± 2.78.

• After the third cycle:
• AMH increased by 0.82 ± 0.44 (statistically significant compared with baseline).
• AFC increased (reported changes in follicle counts were statistically significant overall).
• FSH fell by 2.15 ± 3.625 (the study reports that while FSH tended to decrease, this change was not always statistically significant).

• Pregnancy outcome: overall pregnancy rate reported was 4% after the third cycle follow‑up.

• Overall interpretation: ASCOT was associated with measurable improvements in markers of ovarian reserve (AMH and AFC) for some women. Changes in FSH were inconsistent and not clearly significant across all time points. Clinical pregnancy remained uncommon in this group.

• AMH (anti‑Müllerian hormone): a blood test used to estimate how many small egg follicles remain in the ovaries. Higher AMH usually indicates better ovarian reserve.
• AFC (antral follicle count): number of small follicles seen on ultrasound — another direct sign of how many eggs may be available.
• FSH (follicle‑stimulating hormone): when the ovary is failing, the body raises FSH; a lower FSH after treatment suggests better ovarian responsiveness.

• ASCOT is promising but still experimental. Some women showed improved ovarian reserve tests after treatment, but actual pregnancies were rare in this study.
• Autologous therapy uses a woman’s own cells, which reduces the risk of immune rejection. This highlights why storing your own stem cell sources (cord blood/tissue at birth, or other forms of autologous cell banking) may be valuable: future regenerative procedures could rely on those cells.
• For women concerned about fertility and aging, stem cell–based ovarian treatments could become an option in the future, but more large, controlled trials are needed to confirm benefit and safety.
• If you are considering fertility preservation, current proven options remain egg or embryo freezing. Discuss experimental options carefully with a fertility specialist and consider participating in regulated clinical trials if eligible.

• The study was observational and relatively small (50 patients).
• There was variability between patients in responses, and some early post‑treatment measures did not improve consistently.
• Longer follow‑up and randomized controlled trials are needed to determine real fertility benefits and safety.

Autologous stem cell ovarian transplant (ASCOT) showed encouraging effects on ovarian reserve markers (AMH and AFC) in women with premature ovarian insufficiency, but reductions in FSH were less consistent, and pregnancy rates were low (4% after three cycles). ASCOT may offer a regenerative approach to partially restore ovarian function for some women, but it remains experimental. For people interested in future regenerative fertility options, preserving autologous stem cell sources could expand future choices.

• Banu J, Jahan N, Anwary SA, et al. Effects of autologous stem cell therapy for fertility enhancement among women with premature ovarian insufficiency. Int J Reprod Contracept Obstet Gynecol. 2023. DOI: https://doi.org/10.18203/2320-1770.ijrcog20230114
• Herraiz S, Romeu M, Buigues A, et al. Autologous stem cell ovarian transplantation to increase reproductive potential in patients who are poor responders. Fertil Steril. 2018;110(3):496-505.
• ESHRE Guideline Group on POI (Webber L, Davies M, Anderson R, et al.). ESHRE Guideline: management of women with premature ovarian insufficiency. Hum Reprod. 2016;31(5):926-37.
• Na J, Kim GJ. Recent trends in stem cell therapy for premature ovarian insufficiency and its therapeutic potential: a review. J Ovarian Res. 2020;13(1):74.

If you are interested in how stem cell banking could apply to fertility preservation or future regenerative treatments, talk with your fertility clinic or a stem cell banking provider about current options and the types of cells that can be stored for potential future use.