Autologous Hair Follicle-Derived Secretome and Platelet-Rich Plasma for Premature Ovarian Insufficiency

Participants with premature ovarian insufficiency will receive autologous hair follicle-derived mesenchymal stem cell secretome combined with autologous platelet-rich plasma (PRP). The combined preparation will be administered into the pelvic cul-de-sac through transvaginal ultrasound-guided injection, without direct ovarian injection. Participants will undergo follow-up hormonal assessments and transvaginal ultrasound examinations to evaluate changes in ovarian function. According to the original protocol, an additional injection may be offered to participants who do not demonstrate an adequate response after approximately three months.

Autologous hair follicle-derived mesenchymal stem cell secretome (aHFS) is prepared from hair follicles collected from each participant. On the day of treatment, approximately 20 mL of peripheral blood is collected to prepare autologous platelet-rich plasma (PRP). The PRP is used to reconstitute the participant's aHFS preparation.

The combined aHFS and PRP preparation is administered through a transvaginal ultrasound-guided injection into the pelvic cul-de-sac (pouch of Douglas), without direct injection into the ovaries.

Participants undergo serial hormonal and ultrasound assessments following treatment. According to the original protocol, a second injection may be offered to participants without an adequate ovarian response after approximately three months.

Change in serum follicle-stimulating hormone (FSH) concentration, measured in international units per liter (IU/L), from pretreatment baseline to follow-up. FSH is a hormone involved in regulating ovarian function and is typically elevated in women with premature ovarian insufficiency. Blood samples will be collected to assess changes in FSH levels following treatment. A decrease in FSH may indicate a change in ovarian hormonal activity.

Change in serum anti-Müllerian hormone (AMH) concentration from pretreatment baseline to follow-up. AMH is produced by cells surrounding developing ovarian follicles and is commonly used as a marker of ovarian reserve. Blood samples will be collected to evaluate changes in AMH following treatment. An increase in AMH may suggest a change in ovarian follicular activity.

Change in antral follicle count (AFC), measured using transvaginal ultrasound, from pretreatment baseline to follow-up. Antral follicles are small, fluid-filled structures within the ovaries that contain developing eggs. The number of visible antral follicles will be recorded at each assessment. An increase in AFC may indicate an improvement in measurable ovarian follicular activity.

Number and proportion of participants who achieve a spontaneous pregnancy without assisted reproductive treatment following administration of autologous hair follicle-derived secretome combined with platelet-rich plasma. Pregnancy will be assessed using clinical follow-up and available pregnancy testing results.

Number and proportion of participants who achieve pregnancy following in vitro fertilization (IVF) after treatment with autologous hair follicle-derived secretome combined with platelet-rich plasma. Participants demonstrating sufficient ovarian response may be considered for IVF according to the study protocol. Pregnancy outcomes will be assessed through available clinical follow-up records.