A pilot study from Karolinska Institutet reports on Jun. 24 that immunotherapy may help stimulate egg maturation in women with autoimmune premature ovarian insufficiency, a condition that often results in infertility. Three out of ten women participating in the study gave birth to healthy babies following the treatment.
Premature ovarian insufficiency affects just over three percent of women worldwide and is characterized by the ovaries ceasing to function before age 40. The condition can be caused by autoimmune mechanisms or other factors such as genetics, leading to significantly reduced fertility. Researchers aimed to determine if immunotherapy could make ovaries temporarily responsive to hormonal stimulation in cases where POI is caused by autoimmunity.
The study involved twelve women aged 18–35 diagnosed with autoimmune POI; two withdrew before treatment began. The remaining participants underwent ovarian hormone stimulation both before and four to six months after receiving rituximab, a drug approved for various autoimmune conditions and cancers. Prior to rituximab treatment, none of the women responded to stimulation; after treatment, six out of ten developed follicles allowing for egg retrieval following stimulation.
In five participants, mature eggs were either frozen or fertilized. Three subsequently had embryos transferred, and all three gave birth to healthy babies. Embryo transfer was conducted no earlier than one year post-treatment due to safety considerations. One serious side effect was reported but was linked to hormone stimulation rather than immunotherapy.
It was also noted that all women who responded positively had autoimmune Addison's disease, which involves immune system destruction of the adrenal glands. The research team emphasized that this proof-of-concept study lacked a control group and included only a small number of participants, warranting cautious interpretation of results.
"This is a first step. To determine whether the method is effective and safe, larger, randomised studies are required," said Angelica Lindén Hirschberg. A new randomized study has been launched by the research team.
