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A small pilot study from Sweden has done something no fertility treatment has reliably managed before: it temporarily brought the ovaries back to life in young women whose periods and egg supply had shut down early because of an autoimmune condition.
Of ten women who completed the protocol, three went on to give birth to healthy babies. The researchers, at Karolinska Institutet, used an immunotherapy drug called rituximab to quiet the immune attack on the ovaries, then stimulated egg growth. Their results were published in NEJM Evidence in June 2026.1,2
This is an early proof-of-concept study with no control group and only a handful of participants, so it is a first step rather than a treatment anyone can ask for yet. It also applies specifically to autoimmune premature ovarian insufficiency, not to ordinary age-related menopause. But for a condition that has long been treated as a one-way door, it is a genuinely hopeful outcome.
What is premature ovarian insufficiency?
Premature ovarian insufficiency (POI) is when the ovaries stop working properly before the age of 40. Periods become irregular or stop, oestrogen drops, and natural fertility falls away. It affects just over three per cent of women worldwide.2 You may also see it called premature or early menopause, though POI is the more accurate term, because ovarian function can sometimes flicker on and off rather than ending cleanly.
POI has several possible causes, including genetic differences, cancer treatment, and autoimmunity. We cover the condition in more depth in our guide to premature ovarian failure (or insufficiency), and it sits alongside related cycle problems such as infrequent ovulation.
What does autoimmunity have to do with the ovaries?
In autoimmune POI, the immune system mistakenly targets the ovaries, interfering with the follicles that hold and mature eggs. The thinking behind this study was simple but bold: if the immune attack is what is switching the ovaries off, then calming that attack might let any remaining eggs respond to stimulation again.1,2
Autoimmune POI rarely travels alone. It often comes bundled with other autoimmune conditions, and notably, every woman in this study who responded to treatment also had autoimmune Addison’s disease, where the immune system damages the adrenal glands.2 That clustering is a clue that, in these women, the ovaries had been caught up in a wider immune misfire rather than simply running out of eggs.
What the researchers actually did
The team enrolled twelve women aged 18 to 35 with autoimmune POI. Two withdrew before treatment began, leaving ten who completed the protocol.1,2
Each woman went through ovarian hormone stimulation first, to see how her ovaries responded at baseline. They then received rituximab, an anti-CD20 antibody that depletes the B cells driving the autoimmune process.
Rituximab is not experimental in itself; it is a well-established, approved drug already used for several autoimmune diseases and some cancers. Four to six months later, the women were stimulated again.1,2
The results: from no response to three healthy babies
Before rituximab, none of the women responded to stimulation at all. Afterwards, six of the ten developed follicles, making it possible to retrieve eggs.1,2
In five women, mature eggs could be frozen or fertilised. Three of those women later had embryos transferred and all three gave birth to healthy babies. For safety, embryo transfer happened no earlier than a year after treatment.1,2
As the study’s first author, Professor Angelica Lindén Hirschberg, put it, the findings suggest that in some women an egg reserve remains and can be reactivated once the autoimmune process is suppressed.2 One serious adverse event was reported during the trial, and it was linked to the hormone stimulation rather than to the immunotherapy.1,2
The important caveats
This is a proof-of-concept study, which means it is designed to test whether an idea works at all, not to prove it is safe and effective at scale. There was no control group, the numbers are tiny, and the effect appears to be temporary, opening a window for egg collection rather than permanently restoring fertility.2
It is also specific to autoimmune POI. If your early menopause is genetic, surgical, or related to cancer treatment, this approach has not been shown to help, because there is no autoimmune attack to switch off. The researchers are clear that larger, randomised trials are needed, and they have already started one.2
What this means for your vaginal and pelvic health
POI is not only a fertility story. The early loss of oestrogen affects the whole genitourinary area. Low oestrogen thins and dries vulvovaginal tissue, raises vaginal pH, and shifts the vaginal microbiome away from the protective Lactobacillus species that normally keep it stable, which can mean dryness, irritation, painful sex, and more frequent infections.
This collection of changes is now called genitourinary syndrome of menopause (GSM), and it can show up just as severely when menopause arrives early as it does later in life. We unpack that link in our piece on why early and surgical menopause hit vaginal and urinary tissue hard.
In our clinic, we look after people whose hormones have shifted for all sorts of reasons, and we treat the whole picture rather than a single symptom. We support the vaginal microbiome and tissue locally while the underlying hormonal cause is properly managed by the right specialist.
Immunotherapy for the ovaries is a job for a reproductive immunology and IVF team, but the downstream vaginal effects of low oestrogen are very much the kind of thing we help with day to day. If you are noticing dryness or recurrent imbalance, a comprehensive vaginal microbiome test is a sensible place to start.
Frequently asked questions
Can immunotherapy cure premature menopause?
No. This study showed only a temporary, partial response in women with autoimmune POI, enough to collect eggs in some of them. It is not a cure, and it has not been shown to restore lasting ovarian function.2
Is rituximab a fertility drug?
No. Rituximab is an established immunotherapy used for autoimmune conditions and some cancers. Here it was used off its usual purpose, to dampen the immune attack on the ovaries before standard IVF-style stimulation.1
Does this help age-related menopause?
There is no evidence it does. The approach targets an autoimmune process, so it is not expected to help typical menopause or POI from non-autoimmune causes.2
Can I get this treatment now?
Not as routine care. It was a research study, and larger randomised trials are needed before it could become an established option. Anyone with autoimmune POI hoping to conceive should speak with a reproductive specialist about current evidence-based options and any open trials.2
What to do next
If you have been told you have POI or early menopause, this research is worth knowing about, but the immediate priorities are getting a clear diagnosis of the cause, protecting your bones, heart and long-term health, and managing oestrogen-related symptoms. Fertility questions belong with a reproductive medicine specialist who can talk you through what is realistic for your situation.
For the vaginal and vulval side of low oestrogen, you do not have to wait. If you would like help with dryness, irritation or a disrupted microbiome, you are welcome to book an appointment with our clinic.
This is general information, not a substitute for personalised medical advice.
- Lindén Hirschberg A, Björnsdottir S, Gunnarsson I, Sergouniotis F, Wånggren K, Sousa Silva C, Vogt E, Øksnes M, Husebye ES, Bensing S, Kämpe O. Immunotherapy for Fertility in Autoimmune Premature Ovarian Insufficiency. NEJM Evidence. Published online 23 June 2026. doi:10.1056/EVIDoa2500303.
- Karolinska Institutet. Immunotherapy may temporarily restore fertility in patients of premature menopause. News from Karolinska Institutet. 24 June 2026.
