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OVARIAN REJUVENATION

15 August 2019 Written by   John Giakoumakis

Ovarian biological age has been proven to be a key-determining factor of fertility. New oocytes do not develop in the ovaries and a woman will have a storage of all the eggs she will ever have on the day she is born. It has been established that a woman’s supply of eggs (ovarian reserve) diminishes with time, which in turn results in a decline in both number and quality of oocytes, as she grows older.

The prevalence of poor response to gonadotropin stimulation is approximately 9-24% in women undergoing in vitro fertilization. Female individuals which are deemed low or “poor” responders in hormonal stimulation is associated with increased FSH and decreased AMH values as well as repeated IVF failures. Patients who do not wish to turn to oocyte donation can now have the chance to increase their fertility score with the aid of PRP. 

Science behind Platelet-Rich-Plasma (PRP)

Platelet-rich plasma (PRP) use in the treatment of various medical cases, including osteoarthritis and tendonitis, has been introduced due to its antimicrobial and anti-inflammatory properties. Since the introduction of autologous platelet-rich plasma (PRP) in medical practice, various studies have documented that implementing PRP can enhance healing and the anti-aging process, employing angiogenesis regeneration due to the multiple growth factors and cytokines involved. Platelets are very small components in their blood that normally help with clotting. Platelets carry many growth factors, which are important due to their ability to repair tissue as well as their mitogenic, chemotactic, neovascular and anti-inflammatory effects. These are in little particles within the platelets that during PRP infusion release these cytokines and growth factors into the ovarian tissue, helping the tissue to regenerate. In aged ovarian tissue we aim to utilize the PRP to rejuvenate some of the normal ovarian tissue, stimulate vascularization, in order to improve blood supply, and finally restore some ovarian function.

PRP Technique

In Ovarian Rejuvenation PRP is directly injected into a patient’s ovaries with her own platelet-rich plasma (PRP), infusing the ovaries with proteins rich in growth factors and stem-cell chemoattractants.

The process begins with the patient presenting at the centre fasting whereby 10-12ml of peripheral blood is drawn.
The blood is then harvested with the aid of a kit to separate the plasma part of the blood and further enrich it with growth factors. This can take up to 1 hour.
The patient is then administered IV sedation for approximately 10-12mins. During this time the gynecologist uses an ultrasound-guided dual-lumen needle to infuse each ovary with 1-2ml of PRP.
The procedure is essentially the same as oocyte collection with the only difference being that during PRP we do not aspirate but infuse. The female individual is discharged the same day with minimal adverse reactions.

Following the procedure, patients are monitored for 2-3 months/cycles with blood test for levels of certain reproductive hormones, including Follicle Stimulating Hormone (FSH), Estradiol (E2), and AMH. Furthermore, a vaginal ultrasound is also performed at the time of the blood test in order to count the number of antral follicles present in each ovary.

Candidates for PRP

1. Women above 40 years of age
2. Women with low ovarian reserve (usually diminished AMH values)
3. Women with premature ovarian insufficiency (POI) before the age of 40
4. Women with early peri-menopause

 

Is PRP safe?

PRP has been deemed very safe since it is autologous i.e. it uses the patient’s own blood to infuse the ovaries. There is no risk for infection, no risk of allergic reaction and it is a minimal invasive procedure

Additional Info

  • Author: John Giakoumakis