Reviving Fertility: The Promise of Ovarian Rejuvenation
June 22, 2023
Share to:
Ovarian rejuvenation is an emerging new therapy that offers hope for women struggling with infertility. Even though it is experimental, fertility centers have offered it an option for women based on their infertility history. Current ASRM guidelines do not have a stance on the therapy; however, with evolving data, that may change in the future. According to the Johns Hopkins School of Medicine, the procedure used for ovarian rejuvenation has been successfully used in other fields, including neurology, orthopedics, and dermatology, to treat brain injuries, trauma, hair loss, and skin rejuvenation.
Ovarian reserve is measured using many factors, including blood work for hormones such as FSH and AMH, ultrasound to detect antral follicle count, cycle regularity, and the patient’s age. Fertility specialists use these markers to determine ovarian sufficiency and potentially make a diagnosis of premature ovarian insufficiency (POI) in women under 40 or diminished ovarian reserve (DOR) for women 40 and above. Women who suffer from POI or DOR are prime candidates for ovarian rejuvenation.
PRP Therapy for Fertility
Platelet-rich plasma (PRP) therapy is a procedure founded on the science that the body can heal itself and restore its natural function. According to the International Journal of Molecular Science, PRP contains platelets, growth factors, and cytokines that may accelerate healing and trauma by regenerating tissues. In terms of fertility, PRP therapy is used to restore cell function and may:
-
Induce follicle growth
-
Help egg maturation
-
Enhance natural conception
-
Improve IVF outcomes
-
Increase pregnancy success rates
-
Support egg quality
-
Restore hormone function
Fertility doctors perform ovarian rejuvenation by using a patient’s blood to extract PRP, which is injected into a woman’s ovaries to rejuvenate its function. Risks are minimal and include tissue damage, injection site pain, and infection.
Who Qualifies for Ovarian Rejuvenation?
Candidates for ovarian rejuvenation vary based on their infertility history. Fertility specialists may use several factors to determine candidacy, such as ovarian reserve and ART cycle response. Typically, this therapy is offered for women who have a medical history of:
-
Premature ovarian failure (POF)
-
Diminished ovarian reserve (DOR)
-
Perimenopause
-
Poor response to IVF
-
Recurrent embryo implantation failure
Ovarian Rejuvenation Procedure
Women undergoing ovarian rejuvenation will have their blood drawn by a phlebotomist first. The blood is centrifuged for 10 minutes allowing the plasma to separate from the red blood cells. The plasma is drawn up and removed into a separate vial. Plasma has up to a tenfold higher concentration of growth factors. An anesthesiologist will place the woman under IV sedation (anesthesia). The reproductive endocrinologist will insert an ultrasound probe and needle into the vagina for ultrasound-guided injection of the PRP into the ovaries.
PRP Effects on Embryos
Women who have a diagnosis of DOR, also have a greater chance of producing embryos with chromosomal abnormalties , or having miscarriages. According to the Journal of Clinical and Experimental Reproductive Medicine, there may be a correlation between receiving PRP therapy and producing chromosomally normal (euploid) embryos. This is based on a theory that PRP might enhance the cell division of the egg in its development stages. As a result, the number of chromosomes is within the normal range, which means it will contain 23 chromosomes, as opposed to 22 or 24 chromosomes.
Long-Term Effects of PRP on Ovarian Rejuvenation
Studies suggest ovarian rejuvenation works relatively quickly, in as little as two weeks. Women are encouraged to start fertility treatments or timed intercourse as soon as possible. Despite how quickly it works, the effects typically only last three months. Even though the window is narrow, women can still time the procedure and conception with their fertility doctor or partner.
Although PRP and ovarian rejuvenation offer hope for many women, it is important to consider that there are not enough large randomized controlled trials to base how effective this therapy truly is. That is not to say it is ineffective, but more research needs to be conducted. Having said this, the small studies researched for this article did indicate improvements after PRP therapy was performed on patients with DOR and POF. Improvements were noted in FSH levels, natural conception rates, and the number of eggs retrieved in IVF cycles (compared to cycles before and after therapy).
Sources
Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020. International Journal of Molecular Science. Oct 2021(20):7794. doi: 10.3390/ijms21207794. PMID: 33096812; PMCID: PMC7589810.
Merhi Z, Seckin S, Mouanness M. Intraovarian platelet-rich plasma administration could improve blastocyst euploidy rates in women undergoing in vitro fertilization. Clinical and Experimental Reproductive Medicine. Sep 2022. 49(3):210-214. doi: 10.5653/cerm.2021.05057. Epub 2022 Aug 31. PMID: 36097737; PMCID: PMC9468693.