Assisted Reproduction Add-Ons and Adjuncts

Reactivating Ovarian Function through Autologous Platelet-Rich Plasma Intraovarian Infusion: Pilot Data on Premature Ovarian Insufficiency, Perimenopausal, Menopausal, and Poor Responder Women

Sfakianoudis K, Simopoulou M, Grigoriadis S, Pantou A, Tsioulou P, Maziotis E, Rapani A, Giannelou P, Nitsos N, Kokkali G, Koutsilieris M, Pantos K

Published June 10, 2020 Journal of clinical medicine, 9(6)
DOI 10.3390/jcm9061809 PMID 32532000 PMC PMC7355907

RRM Academy Synopsis

Periods returned after ovarian PRP in 6 of 10 women with POI

Periods returned in 6 out of 10 women with premature ovarian insufficiency after doctors injected platelet-rich plasma (PRP) into their ovaries. Regular cycles returned in 8 out of 10 perimenopausal women. Periods returned in about 4 out of 10 menopausal women.

Key Findings

  • Periods returned in 18 of 30 women with premature ovarian insufficiency (60%). Three of them conceived naturally, and all three had a live birth.
  • Regular cycles returned in 24 of 30 perimenopausal women (80%). Four conceived naturally, one pregnancy ended in miscarriage, and three ended in a live birth.
  • Periods returned in 13 of 30 menopausal women (43.3%). One conceived naturally and had a live birth.
  • Of 30 women with poor ovarian response, 14 (46.6%) had a clinical pregnancy in the ICSI cycle after PRP, and 12 had a live birth. The earlier cycle gave no clinical pregnancy.
  • The authors report no adverse effects in any of the 120 women during the three-month follow-up.

Interpretation

This study followed four groups of women who got ovarian PRP at one Athens clinic. Each group had 30 women. Doctors tracked them for three months. The authors note that PRP should be considered strictly experimental until randomized trials report. The findings support larger, controlled studies of ovarian PRP.

RRM Context

Restorative reproductive medicine asks why ovarian function declined before choosing a next step. For two of the groups studied here, the authors say finding the underlying cause is essential to the women's care.

Abstract

Intraovarian platelet-rich plasma (PRP) infusion was recently introduced in the context of addressing ovarian insufficiency. Reporting on its effectiveness prior to adopting in clinical routine practice is imperative. This study aims to provide pilot data regarding PRP application for ovarian rejuvenation. Four pilot studies were conducted on poor ovarian response (POR), premature ovarian insufficiency (POI), perimenopause, and menopause, respectively. Each pilot study reports on thirty patients, 120 participants were recruited in total. All participants provided written informed consent prior to treatment. Primary outcome measures for the POR pilot study were levels of anti-müllerian hormone (AMH), antral follicle count (AFC) and oocyte yield. For the POI, perimenopausal and menopausal pilot studies primary outcome measures were restoration of menstrual cycle, and Follicle Stimulating Hormone (FSH) levels. A significant improvement on the hormonal profile and the ovarian reserve status was noted, along with improved intracytoplasmic sperm injection (ICSI) cycle performance concerning POR participants. Menstruation recovery was observed in 18 out of 30 POI patients, along with a statistically significant improvement on levels of AMH, FSH, and AFC. Similarly, 13 out of 30 menopausal women positively responded to PRP treatment. Finally, menstruation regularity, improved hormonal levels and AFC were reported for 24 out of 30 perimenopausal women. To conclude, PRP infusion appears to convey promising results in addressing ovarian insufficiency.

Topics

By this author

Related research

Assisted Reproduction › Add-Ons and Adjuncts › Adjunct Evidence Base · Therapeutics › Emerging Therapies › Platelet-Rich Plasma · Reproductive Endocrinology › Ovarian Hormones › Estrogen
Konstantinos Sfakianoudis, Mara Simopoulou, Sokratis Grigoriadis, Agni Pantou, Petroula Tsioulou, Evangelos Maziotis, Anna Rapani, Polina Giannelou, Nikolaos Nitsos, Georgia Kokkali, Michael Koutsilieris, Konstantinos Pantos
K Sfakianoudis, M Simopoulou, S Grigoriadis, A Pantou, P Tsioulou, E Maziotis, A Rapani, P Giannelou, N Nitsos, G Kokkali, Mike Koutsilieris, M Koutsilieris, K Pantos
PMID 32532000 32532000 DOI 10.3390/jcm9061809 10.3390/jcm9061809 Sfakianoudis et al. 2020, Sfakianoudis 2020