Administration of platelet-rich plasma may restore fertility during early menopause: Study
Taiwan: Results from a recent study may bore hopes for women with early menopause who wish to become pregnant. According to the study, published in the journal Menopause, a novel approach of administering gonadotropins and platelet-rich plasma is promising for restoring ovarian function.
The study showed that whole dimension subcortical ovarian administration of platelet-rich plasma with gonadotropin restored ovarian functions, at least temporarily, and could increase pregnancy probability using autologous oocytes in women with early menopause.
In this modern world, most women wish to pursue their careers before attaining motherhood due to which the average age of conceiving a child continues to be pushed back. However, for most of these women, their hope of becoming pregnant is cut short with the early onset of menopause -- described as the cessation of ovarian function at or before the age of 45 years. It is estimated that roughly 12.2% of women experience early menopause. Their only chance of becoming pregnant is with donor eggs.
Multiple treatment options have previously been investigated, including standard, controlled ovarian stimulation. jPlatelet-rich plasma has been used in women with primary ovarian insufficiency, but few pregnancies and live births resulted. With the failure of these somewhat traditional treatments, more novel approaches, such as methods for inducing the growth of ovarian follicles, are being pursued.
Chao Chin Hsu, Taiwan United Birth-promoting Expert Fertility Clinic, Tainan, Taiwan, and colleagues designed this study to investigate if whole dimension subcortical ovarian administration of platelet-rich plasma with gonadotropin, in proximity to most ovarian follicles, is effective in restoring ovarian functions in women during early menopause.
Platelet-rich plasma was was injected into extended subcortical area of bilateral ovaries along with recombinant follicle-stimulating hormone (rFSH) (Gonal-F 300IU) under laparoscopic guidance. The posttreatment ovarian folliculogenesis and serum levels of FSH, luteinizing hormone (LH), and estradiol were followed up for 6 months at weekly to monthly intervals. IVF was carried out in women resuming ovulatory functions.
The study enrolled a total of 12 women with early menopause (mean age of 44.42 ± 2.84).
Key findings of the study include:
- After treatment, 11 women resumed their menstrual period in 37.1 ± 23.5 days.
- Their average serum FSH was 70.47 ± 20.92 and 26.22 ± 17.55 IU/L, luteinizing hormone was 34.81 ± 11.86 and 14.3 ± 12.8 IU/L, before and after treatment, respectively.
- The mid-cycle E2 was 251.1 ± 143.8 pg/mL.
- Ten oocyte retrievals were carried out among six participants, four of them received controlled ovarian stimulation and another two using natural ovulation cycles.
- Thirteen mature eggs were retrieved which were then ICSI fertilized to obtain 10 normally fertilized 2PN oocytes.
- Two participants had cleavage stage embryos transferred of which one achieved clinical pregnancy.
"Whole dimension subcortical ovarian administration of platelet-rich plasma with gonadotropin was shown to restore ovarian functions, at least temporarily, and could increase the probability of pregnancy using autologous oocytes in women with early menopause," wrote the authors.
The study titled, "Resumed ovarian function and pregnancy in early menopausal women by whole dimension subcortical ovarian administration of platelet-rich plasma and gonadotropins," is published in the journal Menopause.