Primary ovarian insufficiency: from basis of pathogenesis to treatment perspectives

2021 ◽  
Vol 20 (5) ◽  
pp. 100-107
Author(s):  
E.N. Andreeva ◽  
◽  
Yu.S. Absatarova ◽  
R.R. Akhmatova ◽  
E.V. Sheremetieva ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Ovarian Tissue ◽  
Reproductive Potential ◽  
Primary Ovarian Insufficiency ◽  
Cochrane Library ◽  
Ovarian Insufficiency ◽  
Autoimmune Pathology ◽  
In Vitro Activation ◽  
Selection Of

The review of literature data on primary ovarian insufficiency (POI), its autoimmune aspect, determination of markers for early diagnosis of the disease, treatment options and implementation of reproductive plans was carried out. Autoimmune and genetic aspects of pathogenesis, markers of autoimmunity in ovarian tissue, which may be promising for early diagnosis in risk groups of patients with autoimmune pathology, were considered; information on the incidence of nosology in other autoimmune diseases, which will also allow to identify POI at early stages, was provided. This article provides information about a new direction in reproductive surgery – drug-free in vitro activation based on primordial follicle activation by modulating biological signaling pathways. This procedure may have a long-term perspective for realizing reproductive potential without the use of donor eggs. The literature search was performed in domestic (eLibrary, CyberLeninka.ru) and international (PubMed, Cochrane Library) databases in Russian and English. The selection of sources was made within a limited period from 2016 to 2021. However, given the insufficient knowledge of the chosen topic, the selection of sources was dated from 2009. Key words: autoimmune oophoritis, hypergonadotropic hypogonadism, primary ovarian insufficiency, in vitro activation

scholarly journals Drug-free in vitro activation for primary ovarian insufficiency

2021 ◽  
Vol 14 (4) ◽  
pp. 443
Author(s):  
NiketH Patel ◽  
HarshaK Bhadarka ◽  
NayanaH Patel ◽  
MolinaNiket Patel
Keyword(s):  
Primary Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
In Vitro Activation ◽  
Drug Free

Drug-free in-vitro activation of follicles and fresh tissue autotransplantation as a therapeutic option in patients with primary ovarian insufficiency

2020 ◽  
Vol 40 (2) ◽  
pp. 254-260 ◽  
Author(s):  
Janisse Ferreri ◽  
Francesc Fàbregues ◽  
Josep Maria Calafell ◽  
Roser Solernou ◽  
Aina Borrás ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Primary Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Fresh Tissue ◽  
In Vitro Activation ◽  
Drug Free

scholarly journals In Vitro Activation: A Dip Into the Primordial Follicle Pool?

2016 ◽  
Vol 101 (10) ◽  
pp. 3568-3570 ◽  
Author(s):  
Ophelia Yin ◽  
Kamaria Cayton ◽  
James H. Segars
Keyword(s):  
Assisted Reproduction ◽  
Ovarian Tissue ◽  
Natural Aging ◽  
Primordial Follicle ◽  
Ovarian Insufficiency ◽  
Future Studies ◽  
Mechanical Signaling ◽  
In Vitro Activation ◽  
A Current

Context: A current limitation of assisted reproduction is the number of available female gametes. This Commentary discusses in vitro activation (IVA), a technique that activates dormant ovarian follicles so that these follicles can become mature oocytes for fertilization. There is considerable evidence that mechanical signaling plays an important role in oocyte maturation and survival; manipulation of the mechanical environment is a key component of the IVA process. IVA acts on existing follicles and does not promote neo-oogenesis, which likely contributes little to the primordial follicle pool in the adult. Conclusions: Several women with primary ovarian insufficiency who underwent the IVA procedure have achieved live births. IVA might also be applicable to women with pathological diminished ovarian reserve and those with physiological diminished reserve due to natural aging. Cancer patients with cryopreserved ovarian tissue also might benefit from IVA. Based on future studies, IVA could prove to be a revolutionary tool for assisted reproduction.

scholarly journals In Vitro Activation of Follicles and Fresh Tissue Auto-transplantation in Primary Ovarian Insufficiency Patients

2016 ◽  
Vol 101 (11) ◽  
pp. 4405-4412 ◽  
Author(s):  
Jun Zhai ◽  
Guidong Yao ◽  
Fangli Dong ◽  
Zhiqin Bu ◽  
Yuan Cheng ◽  
...  
Keyword(s):  
Primary Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Fresh Tissue ◽  
In Vitro Activation

scholarly journals In vitro activation of ovarian cortex and autologous transplantation: A novel approach to primary ovarian insufficiency and diminished ovarian reserve

2020 ◽  
Vol 2020 (4) ◽  
Author(s):  
L Devenutto ◽  
R Quintana ◽  
T Quintana
Keyword(s):  
Ovarian Reserve ◽  
Conflicts Of Interest ◽  
Autologous Transplantation ◽  
Primary Ovarian Insufficiency ◽  
Diminished Ovarian Reserve ◽  
Ovarian Insufficiency ◽  
Primordial Follicles ◽  
Ovarian Cortex ◽  
In Vitro Activation

Abstract BACKGROUND Primary ovarian insufficiency (POI) and diminished ovarian reserve are two conditions that affect women’s fertility. Oocyte donation remains an option for these patients; however, the development of certain novel technologies, such as in vitro activation of ovarian cortex (IVA), enables the possibility of activating the pool of resting primordial follicles, increasing the chance of pregnancy. OBJECTIVE AND RATIONALE Here, we review the main pathways (PI3K and Hippo signaling) that govern the activation of primordial follicles and its application through the development of culture systems that support ovarian cortex for autologous transplantation. We also review the available data from case reports regarding outcomes of pregnancy and live birth rates with IVA. SEARCH METHODS A PubMed search was conducted using the PubMed-NCBI database to identify literature pertinent to the pathways involved in the activation of primordial follicles and the outcomes of IVA techniques from 2013 to the present. OUTCOMES Women with POI have around a 5% chance of spontaneous pregnancy. Recently, novel techniques involving the activation of primordial follicles through molecular pathways have been developed, thus increasing the odds of these patients. More recently, the introduction of a drug-free IVA technique has shown to increase the number of antral follicles with successful oocyte maturation after gonadotropin treatment, reaching pregnancy rates over 30%, either through spontaneous conception or by the implementation of assisted reproductive technology. LIMITATIONS The evidence of this review is based on a few small series, so data should be interpreted with caution, and only randomized controlled trials could estimate the real magnitude and success of the procedure. REASONS FOR CAUTION IVA technique remains an experimental strategy, with limited available data and the requirement of invasive procedures. Moreover, possible carcinogenic effects not yet determined after transplantation require special caution. WIDER IMPLICATIONS In view of the results achieved, IVA could provide a promising option for the preservation of fertility in some cancer patients and prepuberal girls where the only alternative is tissue cryopreservation. STUDY FUNDING/COMPETING INTERESTS The authors received no specific funding for this work and declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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