The potential and mechanism of mesenchymal stem cells in the treatment of premature ovarian failure

Premature ovarian failure (POF), a common endocrine disorder, pertains to the loss of ovarian function in women under the age of 40 years. It is clinically characterized by estrogen deficiency with increased gonadotropin level and amenorrhea, which can lead to loss of fertility and increase the risk of other diseases, including cardiovascular disorders, osteoporosis, and mood disorders. Currently, the most common treatment is hormone replacement therapy (HRT), it relieves menopausal symptoms but does not improve the function of the ovary. Mesenchymal stem cells (MSCs) share the ability of self-renewal and differentiation, playing an important role in the regeneration of injured tissues. Notably, accumulating evidence indicates that MSCs primarily exert their effects through paracrine interactions with the ovarian cortex, rather than contributing to de novo oocyte generation. This suggests that ovarian exhaustion is not complete in POF, leaving a residual ovarian environment that allows MSCs to act. So far, many reports have demonstrated that transplantation of MSCs can improve ovarian structure and function, promote follicular development, and restore hormone levels by anti-apoptosis, promoting angiogenesis, immunomodulation, and anti-oxidation, suggesting the potential of MSCs as alternative therapeutics for POF. Therefore, this study aims to summarize the latest findings on the mechanism and application of MSCs in POF treatment, providing directions for continued research and clinical therapy.