scholarly journals Intraovarian platelet-rich plasma: current status

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Aboubakr Mohamed Elnashar
Keyword(s):  
Ovarian Reserve ◽  
Reproductive Medicine ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Ovarian Response ◽  
Diminished Ovarian Reserve ◽  
Premature Ovarian Insufficiency ◽  
Current Status ◽  
Poor Responders ◽  
Ovarian Insufficiency

Abstract Background The successful use of PRP in regenerative medicine has led investigators to study its effect in the treatment of conditions like decreased ovarian reserve, poor responders, and premature ovarian insufficiency. Objective To review the uses of intraovarian PRP in reproductive medicine. Methods A literature search for English articles related to the uses of intraovarian PRP in reproductive medicine, including articles published in PubMed, from 2000 to April 2021. Results Seventeen studies: No RCT. Studies were classified according to indication. (1) For diminished ovarian reserve: 6 studies including 369 patients. (2). For poor responders: 3 case series studies including 41 patients with an improvement in ovarian response. (3) For premature ovarian insufficiency: 8 studies including 373 patients. Ovarian reserve markers were the outcome of all studies with conflicting results. LBR was not determined in the majority of studies. Conclusion Intraovarian PRP for diminished ovarian reserve, poor ovarian response, or POI is still experimental. Well-designed, large RCTS to confirm its efficacy and safety are required.

Analysis of NR5A1 in 142 patients with premature ovarian insufficiency, diminished ovarian reserve, or unexplained infertility

Maturitas ◽  
2020 ◽  
Vol 131 ◽  
pp. 78-86 ◽  
Author(s):  
Sylvie Jaillard ◽  
Rajini Sreenivasan ◽  
Marion Beaumont ◽  
Gorjana Robevska ◽  
Christèle Dubourg ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Unexplained Infertility ◽  
Diminished Ovarian Reserve ◽  
Premature Ovarian Insufficiency ◽  
Ovarian Insufficiency

scholarly journals Novel Approaches in Addressing Ovarian Insufficiency in 2019: Are We There Yet?

2020 ◽  
Vol 29 ◽  
pp. 096368972092615
Author(s):  
Konstantinos Sfakianoudis ◽  
Anna Rapani ◽  
Sokratis Grigoriadis ◽  
Dimitra Retsina ◽  
Evangelos Maziotis ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Individualized Medicine ◽  
Ovarian Response ◽  
Current Status ◽  
Ovarian Insufficiency ◽  
Novel Treatments ◽  
Mitochondrial Replacement Therapy ◽  
Patient Heterogeneity ◽  
Novel Approaches ◽  
Artificial Gametes

Ovarian insufficiency is described as a multifaceted issue typically encountered in the field of assisted reproduction. The three main identified diagnoses of ovarian insufficiency include premature ovarian failure (POF), poor ovarian response (POR), and advanced maternal age (AMA). Patient heterogeneity in the era of individualized medicine drives research forward leading to the emergence of novel approaches. This plethora of innovative treatments in the service of adequately managing ovarian insufficiency is called to undertake the challenge of addressing infertile patients exploring their reproductive options. This review provides an all-inclusive presentation and critical analysis on novel treatments that have not achieved routine clinical practice status yet, but have recently emerged as promising. In light of the lack of randomized controlled trials conveying safety and efficiency, clinicians are left puzzled in addressing the “how” and “for whom” these approaches may be beneficial. From ovarian injection employing platelet-rich plasma (PRP) or stem cells to artificial gametes and ovaries, ovarian transplantation, and mitochondrial replacement therapy, this descriptive review provides insight toward assisting the practitioner in decision making regarding these cutting-edge treatments. Biological mechanisms, invasiveness levels, efficiency, as well as possible complications, the current status along with bioethical concerns are discussed in the context of identifying future optimal treatment.

scholarly journals Correlation and discordance of anti-mullerian hormone with follicle stimulating hormone in infertile women with premature ovarian insufficiency and diminished ovarian reserve

2020 ◽  
Vol 10 (1) ◽  
pp. 32
Author(s):  
Shakeela Ishrat ◽  
Farzana Deeba ◽  
Shaheen Ara Anwary ◽  
Jesmine Banu
Keyword(s):  
Ovarian Reserve ◽  
Follicle Stimulating Hormone ◽  
Age Groups ◽  
Diminished Ovarian Reserve ◽  
Premature Ovarian Insufficiency ◽  
Age Group ◽  
Ovarian Insufficiency ◽  
Infertile Women ◽  
Younger Age ◽  
Stimulating Hormone

Background: The objective of the study was to explore the correlation and discordance of anti-mullerian hormone (AMH) and follicle stimulating hormone (FSH) in the selected population of premature ovarian insuffiency and diminished ovarian reserve.Methods: This was a retrospective analysis of the data obtained from the women who presented to the Gynae Endocrine Clinic of the Infertility unit of the Department of Obstetrics & Gynaecology from 2015 to 2017. Discordance was defined as abnormal basal FSH (>10 IU/l) with assuring AMH (>1 ng/ml). Statistical analysis was done with SPSS version 23.Results: There were 36 women with premature ovarian insufficiency and 35 women with diminished ovarian reserve. The correlations between basal FSH and AMH are not significant. AMH values are relatively higher in younger age groups. There are extreme high outliers in both POI and DOR groups, more in younger age group. The discordance between AMH and basal FSH was more in women categorized to have diminished ovarian reserve, compared to women with premature ovarian insufficiency.Conclusions: Those women who are younger than 35 years and have high FSH combined with reassuring AMH should be counseled with care regarding the prognosis of their treatment.

scholarly journals In Vitro Follicular Activation and Stem Cell Therapy as a Novel Treatment Strategies in Diminished Ovarian Reserve and Primary Ovarian Insufficiency

2021 ◽  
Vol 11 ◽  
Author(s):  
Francesc Fàbregues ◽  
Janisse Ferreri ◽  
Marta Méndez ◽  
Josep María Calafell ◽  
Jordi Otero ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Therapeutic Option ◽  
Treatment Strategies ◽  
Ovarian Response ◽  
Primary Ovarian Insufficiency ◽  
Diminished Ovarian Reserve ◽  
Hippo Signaling ◽  
Ovarian Insufficiency ◽  
Novel Treatment Strategies

Usually poor ovarian response (POR) to gonadotropins reflects a diminished ovarian reserve (DOR) that gives place to few recruitable follicles despite aggressive stimulation. The reduction in the quantity and quality of the oocytes with advanced age is physiological. However, some women experience DOR much earlier and become prematurely infertile, producing an accelerated follicular depletion towards primary ovarian insufficiency (POI). Up to now, egg donation has been commonly used to treat their infertility. In the last thirty years, specialists in assisted reproduction have focused their attention on the final stages of folliculogenesis, those that depend on the action of gonadotrophins. Nevertheless, recently novel aspects have been known to act in the initial phases, with activating and inhibiting elements. In vitro activation (IVA) combining the in vitro stimulation of the ovarian Akt signaling pathway in ovarian cortex fragments with a method named Hippo-signaling disruption. Later, a simplification of the technique designated Drug-Free IVA have shown encouraging results in patients with POI. Another innovative therapeutic option in these patients is the infusion of bone marrow-derived stem cells (BMDSC) in order to supply an adequate ovarian niche to maintain and/or promote follicular rescue in patients with impaired or aged ovarian reserves. In this review, for the first time, both therapeutic options are addressed together in a common clinical setting. The aim of this review is to analyze the physiological aspects on which these innovative techniques are based; the preliminary results obtained up to now; and the possible therapeutic role that they may have in the future with DOR and POI patients.

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