Birth of a healthy baby in a patient with diminished ovarian reserve after intraovarian autologous platelet-rich plasma injection and an in vitro fertilization program
Background: Diminished ovarian reserve remains one of the most pressing problems in modern reproduction. The use of donor oocytes is an effective way of coping with infertility in patients with decreased ovarian function despite the serious psychological difficulties of this approach. There are presently different experimental methods approved by local ethics committees, which are aimed at improving ovarian function, one of which is the intraovarian injection of a patient’s own platelet-rich plasma (PRP).Kulakova E.V., Kraevaya E.E., Makarova N.P., Kalinina E.A., Nazarenko T.A.
Case report: This paper describes a clinical case of a successful delivery in a patient with a diminished ovarian reserve and a double intraovarian PRP injection. A 34-year-old patient with diminished ovarian reserve who came to the B.V. Leonov Department of Assisted Technologies, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, for infertility treatment, where she received two intraovarian PRP injections, followed by assisted reproductive technologies, resulting in pregnancy and spontaneous delivery of a live full-term fetus.
Conclusion: According to the data available in the literature and to the Department's own accumulated experience in 61 patients, the intraovarian PRP injection may have a short-term positive effect on the ovarian function of patients with diminished ovarian reserve. It is necessary to continue investigations in this area and to gain clinical experience.
Keywords
infertility
diminished ovarian reserve
assisted reproductive technologies
platelet-rich plasma
PRP
References
- Sills E.S., Samuel H.W. Autologous activated platelet-rich plasma injection into adult human ovary tissue: molecular mechanism, analysis, and discussion of reproductive response. Biosci. Rep. 2019; 39(6): BSR20190805. https://dx.doi.org/10.1042/BSR20190805.
- Бондаренко В.В. Применение PRP в дерматологии: обзор современных подходов. Медицинский алфавит. 2021; 9: 55-8. [Bondarenko V.V. The use of PRP in dermatology: a review of modern approaches. Medical alphabet. 2021; 9: 55-8 (in Russian)].
- Потапнев М.П., Загородный Г.М., Кривенко С.И., Богдан В.Г., Свирский А.О., Ясюкевич А.С., Асаевич В.И., Букач Д.В., Эйсмонт О.Л. Современные аспекты применения плазмы, обогащенной растворимыми факторами тромбоцитов, в лечении травм и заболеваний опорно-двигательного аппарата. Спортивная медицина: наука и практика. 2019; 9(4): 33-45. [Potapnev M.P., Zagorodny G.M., Krivenko S.I., Bogdan V.G., Svirsky A.O., Yasyukevich A.S., Asaevich V.I., Bukach D.V., Eismont O.L. Modern aspects of the use of plasma enriched in soluble platelet factors in the treatment of injuries and diseases of the musculoskeletal system. Sports medicine: research and practice. 2019; 9(4): 33-45. (in Russian)]. https://dx.doi.org/10.17238/ISSN2223-2524.2019.4.33.
- Wu P.I., Diaz R, Borg-Stein J. Platelet-rich plasma. J. Phys. Med. Rehabil. Clin. N. Am. 2016; 27(4): 825-53. https://dx.doi.org/10.1016/j.pmr.2016.06.002.
- Женское бесплодие (современные подходы к диагностике и лечению). Клинические рекомендации Министерства здравоохранения РФ. Доступно по: https//roag-portal.ru/projects_gynecology Ссылка активна на 10.05.2021. [Female infertility (modern approaches to diagnosis and treatment). Clinical recommendations of the Ministry of Health of the Russian Federation. (in Russian)]. Available at: https//roag-portal.ru/projects_gynecology Accessed 05.10.2021.
- Tal R., Seifer D.B. Ovarian reserve testing: a user’s guide. Am. J. Obstet. Gynecol. 2017; 217(2): 129-40. https://dx.doi.org/10.1016/j.ajog.2017.02.027.
- Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil. Steril. 2020; 114(6): 1151-7. https://dx.doi.org/10.1016/j.fertnstert.2020.09.134.
- Bos-Mikich A., de Oliveira R., Frantz N. Platelet-rich plasma therapy and reproductive medicine. J. Assist. Reprod. Genet. 2018; 35(5): 753-6. https://dx.doi.org/10.1007/s10815-018-1159-8.
- Dogra Y., Singh N., Vanamail P. Autologous platelet-rich plasma optimizes endometrial thickness and pregnancy outcomes in women with refractory thin endometrium of varied aetiology during fresh and frozen-thawed embryo transfer cycles. JBRA Assist. Reprod. 2022; 26(1): 13-21. https://dx.doi.org/10.5935/1518-0557.20210037.
- Suzuki N., Yoshioka N., Takae S., Sugishita Y., Tamura M., Hashimoto S. et al. Successful fertility preservation following ovarian tissue vitrification in patients with primary ovarian insufficiency. Hum. Reprod. 2015; 30(3): 608-15. https://dx.doi.org/10.1093/humrep/deu353.
- Kawamura K., Kawamura N., Hsueh A.J. Activation of dormant follicles: a new treatment for premature ovarian failure? Curr. Opin. Obstet. Gynecol. 2016; 28(3): 217-22. https://dx.doi.org/10.1097/GCO.0000000000000268.
- Адамян Л.В., Дементьева В.О., Асатурова А.В., Назаренко Т.А. Одноэтапный хирургический метод активации функции яичников (первое клиническое наблюдение). Проблемы репродукции. 2019; 25(1): 97-9. [Adamyan L.V., Dementieva V.O., Asaturova A.V., Nazarenko T.A. One-stage surgical method for activating ovarian function (first clinical observation). Prroblems of Reproduction. 2019; 25(1): 97-9 (in Russian)].
- Liu M., Qiu Y., Xue Z., Wu R., Li J., Niu X. et al. Small extracellular vesicles derived from embryonic stem cells restore ovarian function of premature ovarian failure through PI3K/AKT signaling pathway. Stem Cell Res. Ther. 2020; 11(1): 3. https://dx.doi.org/10.1186/s13287-019-1508-2.
- Liu C., Yin H., Jiang H., Du X., Wang C., Liu Y. et al. Extracellular vesicles derived from mesenchymal stem cells recover fertility of premature ovarian insufficiency mice and the effects on their offspring. Сell Transplant. 2020; 29: 963689720923575. https://dx.doi.org/10.1177/0963689720923575.
- Sfakianoudis K., Simopoulou M., Grigoriadis S., Pantou A., Tsioulou P., Maziotis E. et al. Reactivating ovarian function through autologous platelet-rich plasma intraovarian infusion: pilot data on premature ovarian insufficiency, perimenopausal, menopausal, and poor responder women. J. Clin. Med. 2020; 9(6): 1809. https://dx.doi.org/10.3390/jcm9061809.
- Melo P., Navarro C., Jones C., Coward K., Coleman L. The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non-randomized interventional study. J. Assist. Reprod. Genet . 2020; 37(4): 855-63. https://dx.doi.org/10.1007/s10815-020-01710-z.
- Aflatoonian A., Lotfi M., Saeed L., Tabibnejad N. Effects of intraovarian injection of autologous platelet-rich plasma on ovarian rejuvenation in poor responders and women with primary ovarian insufficiency. Reprod. Sci. 2021; 28(7): 2050-9. https://dx.doi.org/10.1007/s43032-021-00483-9.
- Panda S., Sachan S., Hota S. A systematic review evaluating the efficacy of intra-ovarian infusion of autologous platelet-rich plasma in patients with poor ovarian reserve or ovarian insufficiency. Cureus. 2020; 12(12): e12037. https://dx.doi.org/10.7759/cureus.12037.
- Cakiroglu Y., Saltik A., Yuceturk A., Karaosmanoglu O., Kopuk S.Y., Scott R.T. et al. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency. Aging (Albany NY). 2020; 12(11): 10211-22. https://dx.doi.org/10.18632/aging.103403.
Received 01.02.2022
Accepted 02.03.2022
About the Authors
Elena V. Kulakova, Ph.D., Senior Researcher at the B.V. Leonov Department of Assisted Technologies for the Treatment of Infertility, V.I. Kulakov NMRC for OG&P,Ministry of Health of Russia, e_kulakova@oparina4.ru, 117997, Russia, Moscow, Academician Oparin str., 4.
Elizaveta E. Kraevaya, Ph.D., Junior Researcher at the B.V. Leonov Department of Assisted Technologies for the Treatment of Infertility, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, e_kraevaya@oparina4.ru, 117997, Russia, Moscow, Academician Oparin str., 4.
Natalia P. Makarova, Dr. Biol. Sci., Senior Researcher at the B.V. Leonov Department of Assisted Technologies for the Treatment of Infertility, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, np_makarova@oparina4.ru, 117997, Russia, Moscow, Academician Oparin str., 4.
Elena A. Kalinina, Dr. Med. Sci., Professor, Head of the B.V. Leonov Department of Assisted Technologies for the Treatment of Infertility, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia, e_kalinina@oparina4.ru, 117997, Russia, Moscow, Academician Oparin str., 4.
Tatyana A. Nazarenko, Dr. Med. Sci., Professor, Director of the Institute of Reproductive Medicine, V.I. Kulakov NMRC for OG&P, Ministry of Health of Russia,
t_nazarenko@oparina4.ru, 117997, Russia, Moscow, Akademika Oparina str., 4.
Authors' contributions: Kulakova E.V., Kraevaya E.E. – collection and analysis of literature data, processing of the original material and writing the article; Kulakova E.V. – implementation of ART and PRP programs in the patient; Makarova N.P., Kalinina E.A., Nazarenko T.A. – editing and approval of the publication.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The investigation was conducted without attracting additional funding from third parties.
Ethical Approval: The investigation has been approved by the Ethics Committee in Biomedical Research, Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
Patient Consent for Publication: The patient provided informed consent for the publication of her data.
For citation: Kulakova E.V., Kraevaya E.E., Makarova N.P., Kalinina E.A., Nazarenko T.A. Birth of a healthy baby in a patient with diminished ovarian reserve after intraovarian autologous platelet-rich plasma injection and an in vitro fertilization program.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 5: 157-161 (in Russian)
https://dx.doi.org/10.18565/aig.2022.5.157-161
Similar Articles
