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By Daniella Gray
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A small but promising study suggests that immunotherapy could help restore fertility in some women diagnosed with premature menopause, offering new hope for patients who have long faced limited treatment options.
The research led by researchers at Karolinska Institutet, published in NEJM Evidence, focuses on women with premature ovarian insufficiency (POI), a condition in which the ovaries stop functioning before the age of 40.
Affecting just over 3% of women worldwide, POI often leads to infertility and can be particularly devastating for those hoping to conceive.
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"This study is significant because it challenges the long-held assumption that premature menopause is always permanent, especially in autoimmune contexts," Margaret Quinlan, professor of communication studies and director of health and medical humanities at University of North Carolina, told Newsweek.
Even so, replication, clearer protocols and careful patient selection will all be needed before immunotherapy can be used routinely, Quinlan added.
In the new study, researchers explored whether a type of immunotherapy could temporarily “switch on” ovarian activity in women whose condition is linked to autoimmune disease—where the body’s immune system mistakenly attacks healthy tissue.
The team enrolled 12 women aged between 18 and 35 with autoimmune-related POI. Two withdrew early, leaving 10 who completed the treatment.
Before receiving immunotherapy, none of the participants responded to hormonal stimulation, meaning their ovaries were not producing mature eggs.
However, after treatment with rituximab—a drug commonly used to treat autoimmune conditions and some cancers—results began to shift.
Within four to six months, six of the 10 women developed ovarian follicles in response to stimulation, making it possible to retrieve eggs.
In five women, clinicians were able to collect mature eggs that could be frozen or fertilized. Three went on to have embryos implanted, and all three later gave birth to healthy babies.
The findings suggest that, even in women with premature menopause, dormant egg reserves may still exist—and could potentially be reactivated if the underlying autoimmune response is suppressed.
Quinlan, who was diagnosed with early menopause at 44 and experienced premature ovarian failure without initially recognizing that she had been in perimenopause, said the findings were "compelling" but said there's still a sense of caution around it.
"They suggest a future in which some cases of infertility linked to autoimmunity might be treatable, but we need rigorous evidence before translating this into care," she said.
The treatment itself works by targeting B cells, a type of immune cell involved in autoimmune reactions.
By calming this immune activity, researchers believe the ovaries may regain some sensitivity to hormonal signals, allowing eggs to mature again.
Despite the encouraging results, the researchers stress that the study is small and should be interpreted cautiously. It was designed as a “proof-of-concept,” meaning its primary goal was to test whether the idea could work—not to definitively prove it as a treatment.
There were also safety considerations. One serious side effect occurred during the study, although it was linked to the hormone stimulation process rather than the immunotherapy itself.
Another notable detail is that all the women who responded to treatment had Addison’s disease, an autoimmune condition that affects the adrenal glands.
This may suggest that the therapy works best for specific subgroups of patients, though more research is needed to confirm this.
Quinlan said the findings highlight significant gaps in our understanding of ovarian function.
"For now, this is an important step forward—not a clinical breakthrough just yet," she said.
Reference
Hirschberg, A.L., Björnsdottir, S., Gunnarsson, I., Sergouniotis, F., Wånggren, K., Sousa Silva, C., Vogt, E., Øksnes, M., Husebye, E.S., Bensing, S. and Kämpe, O. (2026). Immunotherapy for Fertility in Autoimmune Premature Ovarian Insufficiency. NEJM Evidence, 5(7). doi:https://doi.org/10.1056/evidoa2500303.
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