DISCUSSIONPrevious studies10,20 have demonstrated that hAECs are an excellent source of seed stem cells, which may be used in regenerative therapies for a variety of diseases, and the paracrine potential of hAECs has been proven in many animal studies. The present study was the first to report that hAEC exosomes exhibit a therapeutic effect similar to the paracrine action of hAECs in chemotherapy-induced POF mice.hAEC-exosome transplantation not only protected follicles from chemotherapy-induced ovary mage but also repaired ovarian function of POF mice, including enhancing metabolic pathways, PPAR ignaling pathways, and AMPK signaling pathways. A previous study demonstrated that PPARg and AMPK signaling pathways play a role in energy control and lipid metabolism. In mice, the absence of PPAR in ovaries results in lower levels of fertility.