Innovative therapies in diminished ovarian reserve and primary ovarian insufficiency

Premature or primary ovarian insufficiency (POI) is characterized by the loss of ovarian function in women under 40 years of age, with a prevalence of 1% of the female population. Women with POI face subfertility and premature symptoms associated with menopause. Currently, reproductive options for these patients are limited, primarily relying on oocyte donation. However, recent advances in the knowledge of the initial phases of folliculogenesis have allowed the proposal of new therapeutic strategies to try to restore ovarian function in these patients. In this paper, the physiological background, preliminary results on POI and DOR (decreased ovarian reserve) patients, as well as future challenges associated with these innovative treatments are addressed. The ovarian reactivation strategies analyzed in this review include surgical procedures (IVA and Drug-Free IVA), the infusion of growth factors from activated platelets (Platelet-Rich Plasma) or the use of stem cells and factors released by them (Stem Cell-Based Therapy), and the use of mitochondrial transfer therapies. (c) 2024 Elsevier Espa & ntilde;a, S.L.U. All rights reserved.