Premature ovarian insufficiency (POI) is a heterogeneous disorder, and cyclophosphamide (CTX)-induced ovarian injury represents an acquired POI-like condition rather than the full clinical spectrum of POI. In this study, CTX was used to establish a granulosa cell dysfunction model to evaluate whether primed avian mesenchymal stem cell-derived small extracellular vesicles (primed AMSC-sEVs) could restore granulosa cell homeostasis under human menopausal gonadotropin (hMG) stimulation, a clinically relevant gonadotropin context used in ovarian stimulation. Human granulosa cells were exposed to CTX and subsequently treated with hMG, naïve AMSC-sEVs, or primed AMSC-sEVs. Cell viability, mitochondrial membrane potential, AMH and FSHR expression, and hormone secretion were examined. CTX reduced cell viability, mitochondrial membrane potential, AMH and FSHR expression, and AMH/estradiol secretion, confirming the establishment of a POI-like granulosa cell dysfunction state. hMG partially restored selected functional markers but showed limited effects on cell viability and mitochondrial recovery. In contrast, primed AMSC-sEVs markedly restored granulosa cell viability, mitochondrial membrane potential, AMH and FSHR expression, and endocrine output, with stronger effects than naïve AMSC-sEVs. Co-treatment with hMG did not consistently enhance the restorative effects of primed AMSC-sEVs beyond those achieved by primed AMSC-sEVs alone. These findings indicate that primed AMSC-sEVs primarily act by restoring granulosa cell and mitochondrial homeostasis, thereby supporting the cellular competence required for gonadotropin responsiveness in an acquired POI-like condition.

(1) Background: Ectopic pregnancy (EP) is when fertilized ovum implanted outside of uterine cavity. The incidence was 1.5% to 2.0% of all pregnancies [1, 2]. EP decreases fertility ability [3]. This study focused on the pregnancy rate after EP and various parameters influencing pregnancy. (2) Methods: The data was extracted from National Health Insurance Research Database (NHIRD) during 2000-2013. The study group enrolled women with one EP history. Those who did not have EP was put into the control group. Chi-square/Fisher exact test was performed on category variable and t-test was used on continue variables. (3) Results: The EP group had a higher cumulative rate of conceive, 41.55% than control group, 37.14% and 1.16 times higher risk in developing pregnancy (P<0.001). The conceiving rate was lower than the control group in the first 5 years, but higher than the control group in the 10th to 14th years. (4) Conclusions: The fecundability after EP is lower at the beginning, but regained after long term follow.