News | Repurposing an Existing Drug: Kidney Medication Finerenone May Offer New Hope for POI Treatment
A new study suggests that an oral drug originally used to treat kidney disease may offer a new fertility treatment for women with premature ovarian insufficiency (POI). Researchers found that the antifibrotic drug Finerenone promoted follicular development and, in a preliminary clinical study, helped some patients with POI produce mature eggs suitable for in vitro fertilization (IVF).
The research was conducted jointly by the team of Professor Kazuhiro Kawamura at Juntendo University in Japan and the team of Professor Kui Liu at the University of Hong Kong (HKU). The findings were published in Science on February 5, 2026.
Premature Ovarian Insufficiency Affects 1%–3% of Reproductive-Age Women
Premature ovarian insufficiency is a major cause of female infertility, affecting about 1% to 3% of women of reproductive age. Patients commonly experience cessation of menstruation, reduced estrogen levels, and elevated follicle-stimulating hormone (FSH).
Although many patients with POI retain some primordial follicles in their ovaries, these follicles often do not develop on their own. Because FSH levels are already high, the follicles also typically do not respond effectively to conventional ovarian stimulation.
Kawamura’s team previously developed an in-vitro activation (IVA) technique. The method cultures ovarian cortical tissue and activates its small follicles before transplanting the tissue back into the patient by laparoscopic surgery. It has resulted in pregnancies and live births in some patients.
The theoretical basis for this technique came from research by Liu’s team at the University of Hong Kong. They found that the mTORC1 signaling pathway in granulosa cells and the PI3K signaling pathway in oocytes are critical to follicle formation.
Professor Kawamura explained: “Based on this mechanism, we developed in-vitro activation to restore fertility by activating small follicles in the ovarian cortex of patients with POI and performing autologous transplantation.”
Seeking a Treatment Without Surgery
In the new study, researchers sought a way to activate follicles without invasive surgery. They noted that some drugs capable of activating the mTORC1 and PI3K signaling pathways are already used to treat kidney disease.
The team therefore asked whether these approved drugs could be repurposed to restore fertility in women with POI.
After screening, the researchers focused on Finerenone. This mineralocorticoid receptor antagonist has antifibrotic effects and has demonstrated a good safety profile in patients with chronic kidney disease.
In laboratory experiments, researchers cultured immature mouse ovaries with Finerenone. The ovaries began forming follicles and eventually produced mature oocytes.
Mouse Experiments Show Improved Fertility
The team then investigated the finding further in animal models.
Over an 18-week experiment, mice given oral Finerenone produced significantly more offspring than the placebo group. The drug also induced new follicle formation in mice infertile because of age-related decline in ovarian function.
Gene expression analysis showed that Finerenone inhibited collagen production in the ovarian cortex. Excess collagen deposition stiffens tissue through fibrosis, physically restricting the growth of small follicles.
Professor Kawamura said: “The antifibrotic effect of Finerenone can reduce the extracellular matrix restriction on the growth of small follicles, allowing them to continue developing.”
The study also found that signaling between ovarian stromal collagen and granulosa cells may be an important negative regulator of follicular development.
To test this hypothesis, the researchers evaluated two other antifibrotic drugs, Nintedanib and Ruxolitinib. Both inhibit fibrosis through different mechanisms and likewise induced follicle formation in mouse ovaries, further supporting the theory that collagen restricts follicular development.
Preliminary Human Study: Some Patients Produced Mature Eggs
Following positive animal results, the team conducted a preliminary clinical exploratory study at the University of Hong Kong-Shenzhen Hospital.
The study included 14 patients with POI who took oral Finerenone for 3 to 7 months. Results showed:
Follicular development was observed in all patients
Seven patients produced mature eggs suitable for IVF
The researchers noted that the retrieved oocytes were comparable in quality to those from women of the same age without POI who were undergoing IVF.
Although the study was small, the results suggest that antifibrotic treatment may help activate residual follicles in some women with POI.
A New Approach to POI Treatment
The team believes that if larger clinical trials confirm the finding, antifibrotic medication could become a simpler, less invasive treatment.
Professor Kawamura said: “Further investigation of FDA-approved oral antifibrotic drugs for activating small ovarian follicles may provide a new treatment pathway for infertility associated with POI.”
The researchers noted that this strategy could reduce reliance on surgical treatment and offer women with POI worldwide more reproductive options.
News | Repurposing an Existing Drug: Kidney Medication Finerenone May Offer New Hope for POI Treatment
News | Repurposing an Existing Drug: Kidney Medication Finerenone May Offer New Hope for POI Treatment
A new study suggests that an oral drug originally used to treat kidney disease may offer a new fertility treatment for women with premature ovarian insufficiency (POI). Researchers found that the antifibrotic drug Finerenone promoted follicular development and, in a preliminary clinical study, helped some patients with POI produce mature eggs suitable for in vitro fertilization (IVF).
The research was conducted jointly by the team of Professor Kazuhiro Kawamura at Juntendo University in Japan and the team of Professor Kui Liu at the University of Hong Kong (HKU). The findings were published in Science on February 5, 2026.
Premature Ovarian Insufficiency Affects 1%–3% of Reproductive-Age Women
Premature ovarian insufficiency is a major cause of female infertility, affecting about 1% to 3% of women of reproductive age. Patients commonly experience cessation of menstruation, reduced estrogen levels, and elevated follicle-stimulating hormone (FSH).
Although many patients with POI retain some primordial follicles in their ovaries, these follicles often do not develop on their own. Because FSH levels are already high, the follicles also typically do not respond effectively to conventional ovarian stimulation.
Kawamura’s team previously developed an in-vitro activation (IVA) technique. The method cultures ovarian cortical tissue and activates its small follicles before transplanting the tissue back into the patient by laparoscopic surgery. It has resulted in pregnancies and live births in some patients.
The theoretical basis for this technique came from research by Liu’s team at the University of Hong Kong. They found that the mTORC1 signaling pathway in granulosa cells and the PI3K signaling pathway in oocytes are critical to follicle formation.
Professor Kawamura explained: “Based on this mechanism, we developed in-vitro activation to restore fertility by activating small follicles in the ovarian cortex of patients with POI and performing autologous transplantation.”
Seeking a Treatment Without Surgery
In the new study, researchers sought a way to activate follicles without invasive surgery. They noted that some drugs capable of activating the mTORC1 and PI3K signaling pathways are already used to treat kidney disease.
The team therefore asked whether these approved drugs could be repurposed to restore fertility in women with POI.
After screening, the researchers focused on Finerenone. This mineralocorticoid receptor antagonist has antifibrotic effects and has demonstrated a good safety profile in patients with chronic kidney disease.
In laboratory experiments, researchers cultured immature mouse ovaries with Finerenone. The ovaries began forming follicles and eventually produced mature oocytes.
Mouse Experiments Show Improved Fertility
The team then investigated the finding further in animal models.
Over an 18-week experiment, mice given oral Finerenone produced significantly more offspring than the placebo group. The drug also induced new follicle formation in mice infertile because of age-related decline in ovarian function.
Gene expression analysis showed that Finerenone inhibited collagen production in the ovarian cortex. Excess collagen deposition stiffens tissue through fibrosis, physically restricting the growth of small follicles.
Professor Kawamura said: “The antifibrotic effect of Finerenone can reduce the extracellular matrix restriction on the growth of small follicles, allowing them to continue developing.”
The study also found that signaling between ovarian stromal collagen and granulosa cells may be an important negative regulator of follicular development.
To test this hypothesis, the researchers evaluated two other antifibrotic drugs, Nintedanib and Ruxolitinib. Both inhibit fibrosis through different mechanisms and likewise induced follicle formation in mouse ovaries, further supporting the theory that collagen restricts follicular development.
Preliminary Human Study: Some Patients Produced Mature Eggs
Following positive animal results, the team conducted a preliminary clinical exploratory study at the University of Hong Kong-Shenzhen Hospital.
The study included 14 patients with POI who took oral Finerenone for 3 to 7 months. Results showed:
Follicular development was observed in all patients
Seven patients produced mature eggs suitable for IVF
The researchers noted that the retrieved oocytes were comparable in quality to those from women of the same age without POI who were undergoing IVF.
Although the study was small, the results suggest that antifibrotic treatment may help activate residual follicles in some women with POI.
A New Approach to POI Treatment
The team believes that if larger clinical trials confirm the finding, antifibrotic medication could become a simpler, less invasive treatment.
Professor Kawamura said: “Further investigation of FDA-approved oral antifibrotic drugs for activating small ovarian follicles may provide a new treatment pathway for infertility associated with POI.”
The researchers noted that this strategy could reduce reliance on surgical treatment and offer women with POI worldwide more reproductive options.
Story source:
Collected online