Study question: To investigate whether adipose tissue-derived stem cells (ASCs) modulate hypoxia and oxidative stress in human ovarian tissue transplants to reduce early follicle loss. Summary answer: ASCs protect the follicle pool by mitigating the hypoxia-related response through HIF1α signaling in human xenografts and enhancing revascularization by ensuring faster tissue reperfusion. What is known already: ASCs are known for their angiogenic potential and capacity to boost angiogenesis by secreting growth factors and differentiating into vessels in numerous models of wound healing in regenerative medicine. In a 2-step ovarian tissue xenotransplantation involving grafting inside a fibrin scaffold two weeks prior to transplantation, ASCs reduced follicle loss after short- and long-term grafting, as well as abnormal follicle activation, by increasing reoxygenation and revascularization in human xenografts.