Ovarian Rejuvenation Using Platelet-Rich Plasma: a Promising Option for Women in Early Menopause to Have a Baby
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INFERTILITY: COMMENTARY
Ovarian Rejuvenation Using Platelet-Rich Plasma: a Promising Option for Women in Early Menopause to Have a Baby Hang-soo Park 1
&
Mara Ulin 1 & Esra Cetin 1
Received: 24 August 2020 / Accepted: 6 September 2020 # Society for Reproductive Investigation 2020
Keywords Infertility . Low ovarian reserve . Primary ovarian insufficiency . Platelet-rich autologous plasma
Today, a large proportion of infertility cases are related to ovarian insufficiency as a result of diminished ovarian reserve. This condition is defined by a loss of small follicles or a decrease in the quality of existing follicles, and thus a reduction in the potential to produce mature oocyte competent for fertilization. In women of reproductive age, ovarian insufficiency can be caused by various factors, including unilateral ovarian absence, previous ovarian surgery, aneuploidy, smoking, unexplained infertility, chemotherapy/radiotherapy exposure, and various environmental factors. Additionally, the trend in delaying childbearing due to lifestyle preferences may culminate in ovarian insufficiency, as the quality and quantity of viable eggs decrease with age. Social egg freezing is a good preventive treatment option, but it remains difficult to counsel patients prior to a diagnosis of diminished ovarian reserve, and it does not guarantee a pregnancy. While in vitro fertilization continues to be the first-line treatment therapy, it may also be unsuccessful due to poor egg quality. The use of donor oocytes is another solid option, but ethical concerns, high cost, and psychological factors may limit its use. Thus, few treatment options are available for restoring fertility in women with low ovarian reserve, and there is a clear need for new approaches to help women suffering from this condition. Several ongoing trials are investigating approaches to rescue or regenerate oocytes and restore fertility in women with ovarian insufficiency—these approaches include in vitro oocyte activation, stem cell therapies (umbilical cord mesenchymal stem cells and autologous bone marrow stem cells), and
* Hang-soo Park [email protected] 1
Department of Surgery, College of Medicine, University of Illinois at Chicago, COMRB 7100 909 S Wolcott Ave., Chicago, IL 60612, USA
the use of platelet-rich plasma (PRP). Many recent regenerative medicine studies support the utility of PRP for the treatment of various diseases. PRP is composed of platelets in a small volume of plasma containing high concentrations of platelet-derived growth factors and cytokines. As an autogenous preparation, treatment with PRP eliminates concerns about transmissible diseases and immune rejection. Results from the first clinical trial of PRP for female infertility were reported in 2016, and 13 PRP clinical trials are currently registered according to clinicaltrials.gov. Most of these are actively recruiting the participants or patients, and only one has been completed in the USA [1]. A study in 2018 demonstrated that PRP treatment through intraovarian injection under transv
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