Ovarian revitalization

We define OVARIAN REVITALIZATION as any technique capable of revitalizing/reactivating ovaries that no longer function or function poorly. Ovarian rejuvenation/revitalization is a novel technology that has led to significant clinical advances in the field of reproductive medicine in recent years.

Technique

We know today that even if the ovaries do not function and the woman no longer has periods, the ovaries maintain a number of dormant follicles with the possibility of being reactivated by the ovarian machinery, promoting the return of normal ovarian function with menstruation and ovulation in some cases.

This technique is used not only for women who are already in early menopause but also for those women with low ovarian reserve, with low or poor response to stimulation of their follicles in an in vitro fertilization IVF treatment. Basically in cases of low performance to precise stimulation and adequate ovarian puncture.

One ovarian rejuvenation technique is the intraovarian injection of platelet-rich plasma, the so-called ovarian PRP. It is a simple technique where a portion of the patient's own plasma (once prepared) is introduced into her ovaries. The injection of platelet-rich plasma into the ovaries aims to improve ovarian function.

Platelets are cells present in our bloodstream and possess factors capable of regenerating and activating other tissues. Thus, by injecting platelet-rich plasma into the ovaries we deposit a large quantity of growth factors that could promote good functioning of the ovarian “machinery”, repairing and regenerating the ovaries, restoring their function.

How does it work?

The patient arrives at the centre and we draw blood from her (as if for an analysis). This blood is prepared for approximately 30 minutes to isolate the part rich in platelets and their activating products. This prepared portion is injected into the ovaries after an ovarian puncture. Since the products are extracted from the patient's own blood, there is no risk of rejection.

The patient is sedated (she sleeps but breathes on her own) and we perform a transvaginal ultrasound through which we can access the ovaries with a needle and inject the activating products. The entire procedure takes about 20 minutes and is painless since anesthesia is used and does not require hospitalization.

After performing ovarian activation with PRP, an IVF cycle is done within the next 120 days.

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What are its benefits?

Improve hormone levels, as well as improve the response in quantity and quality of eggs in which an in vitro fertilization procedure is repeated.

As for the risks: they are similar to those of traditional ovarian puncture in any IVF procedure: anesthesia, peritoneal infection, bleeding due to accidental puncture of blood vessels or the ovary itself, puncture of intestinal loop or other structures; and ovarian torsion.

After the procedure, patients should continue with the proposed treatment. As this is a relatively new technique, it can be classified as experimental and, therefore, time and the appearance of more publications will clearly determine its exact usefulness.

If you are interested in PRP Ovarian Rejuvenation and/or stem cell therapy, call our offices today to schedule an appointment: we evaluate cases on an individual and personalized basis.

Publications that support the technique

Referencias bibliográficas:

Seckin S, Ramadan H, Mouanness M, Kohansieh M, Merhi Z. Ovarian response to intraovarian platelet-rich plasma (PRP) administration: hypotheses and potential mechanisms of action. J Assist Reprod Genet. 2022 Jan;39(1):37-61. doi: 10.1007/s10815-021-02385-w. Epub 2022 Feb 17. PMID: 35175511; PMCID: PMC8866624.

Herlihy NS, Seli E. The use of intraovarian injection of autologous platelet rich plasma (PRP) in patients with poor ovarian response and premature ovarian insufficiency. Curr Opin Obstet Gynecol. 2022 Jun 1;34(3):133-137. doi: 10.1097/GCO.0000000000000784. PMID: 35645011.

Aflatoonian A, Lotfi M, Saeed L, Tabibnejad N. Effects of Intraovarian Injection of Autologous Platelet-Rich Plasma on Ovarian Rejuvenation in Poor Responders and Women with Primary Ovarian Insufficiency. Reprod Sci. 2021 Jul;28(7):2050-2059. doi: 10.1007/s43032-021-00483-9. Epub 2021 Mar 8. PMID: 33683669.

Atkinson L, Martin F, Sturmey RG. Intraovarian injection of platelet-rich plasma in assisted reproduction: too much too soon? Hum Reprod. 2021 Jun 18;36(7):1737-1750. doi: 10.1093/humrep/deab106. PMID: 33963408; PMCID: PMC8366566.

Ferrari AR, Cortrezzi S, Borges E Junior, Braga D, Souza MDCB, Antunes RA. Evaluation of the Effects of Platelet-Rich Plasma on Follicular and Endometrial Growth: A Literature Review. JBRA Assist Reprod. 2021 Oct 4;25(4):601-607. doi: 10.5935/1518-0557.20210036. PMID: 34415119; PMCID: PMC8489815.

Cakiroglu Y, Saltik A, Yuceturk A, Karaosmanoglu O, Kopuk SY, Scott RT, Tiras B, Seli E. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency. Aging (Albany NY). 2020 Jun 5;12(11):10211-10222. doi: 10.18632/aging.103403. Epub 2020 Jun 5. PMID: 32507764; PMCID: PMC7346073.

Melo P, Navarro C, Jones C, Coward K, Coleman L. The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non-randomized interventional study. J Assist Reprod Genet. 2020 Apr;37(4):855-863. doi: 10.1007/s10815-020-01710-z. Epub 2020 Feb 7. PMID: 32030554; PMCID: PMC7183031.

Petryk N, Petryk M. Ovarian Rejuvenation Through Platelet-Rich Autologous Plasma (PRP)-a Chance to Have a Baby Without Donor Eggs, Improving the Life Quality of Women Suffering from Early Menopause Without Synthetic Hormonal Treatment. Reprod Sci. 2020 Nov;27(11):1975-1982. doi: 10.1007/s43032-020-00266-8. Epub 2020 Jul 22. PMID: 32700285.