1
|
Panda SR, 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:e12037. [PMID: 33457137 PMCID: PMC7797441 DOI: 10.7759/cureus.12037] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The emergence of autologous platelet-rich plasma (PRP) therapy reflects a break-through for infertile patients with premature ovarian failure. To study the efficacy of intra-ovarian infusion of autologous PRP on the improvement of ovarian reserve parameters and the subsequent artificial reproductive technique (ART) cycle outcomes in infertile women with poor ovarian reserve or premature ovarian insufficiency, a systematic search in electronic databases like Medline (through PubMed), Embase, Scopus, Web of Science, and Cochrane was done using relevant search terms. Except for case series, case reports, and review articles, all other types of studies, those evaluated for the effects of intra-ovarian infusion of PRP in subfertile women for decreased ovarian reserve (DOR) or premature ovarian insufficiency (POI) were included in our systematic review. The data were extracted from each eligible study and cross-checked by two authors. Intra-ovarian PRP infusion appears to be effective in ovarian rejuvenation, and the results of the subsequent intracytoplasmic sperm injection (ICSI) cycle are encouraging. PRP intervention was found to be beneficial in terms of an improvement in ovarian reserve parameters (increase in serum anti-mullerian hormone or antral follicle count or decrease in serum follicular stimulating hormone). ICSI cycle performance in terms of the total number of oocytes retrieved, number of two-pronuclei embryos, fertilization rate, number of cleavage stage embryos, number of good quality embryos, and cycle cancellation rate were found to be improved after intra-ovarian PRP infusion as compared to their previous cycle without PRP infusion.
Collapse
Affiliation(s)
- Soumya R Panda
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Mangalagiri, Guntur, IND
| | - Shikha Sachan
- Obstetrics and Gynaecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND
| | - Smrutismita Hota
- Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Mangalagiri, Guntur, IND
| |
Collapse
|
2
|
Sfakianoudis K, Simopoulou M, Grigoriadis S, Pantou A, Tsioulou P, Maziotis E, Rapani A, Giannelou P, Nitsos N, Kokkali G, Koutsilieris M, Pantos K. 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:jcm9061809. [PMID: 32532000 PMCID: PMC7355907 DOI: 10.3390/jcm9061809] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/04/2020] [Accepted: 06/08/2020] [Indexed: 12/14/2022] Open
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.
Collapse
Affiliation(s)
- Konstantinos Sfakianoudis
- Centre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, Greece; (K.S.); (A.P.); (P.G.); (N.N.); (G.K.); (K.P.)
| | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece; (S.G.); (P.T.); (E.M.); (A.R.); (M.K.)
- Correspondence: ; Tel.: +30-2107462592; Fax: +30-2107462571
| | - Sokratis Grigoriadis
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece; (S.G.); (P.T.); (E.M.); (A.R.); (M.K.)
| | - Agni Pantou
- Centre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, Greece; (K.S.); (A.P.); (P.G.); (N.N.); (G.K.); (K.P.)
| | - Petroula Tsioulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece; (S.G.); (P.T.); (E.M.); (A.R.); (M.K.)
| | - Evangelos Maziotis
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece; (S.G.); (P.T.); (E.M.); (A.R.); (M.K.)
| | - Anna Rapani
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece; (S.G.); (P.T.); (E.M.); (A.R.); (M.K.)
| | - Polina Giannelou
- Centre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, Greece; (K.S.); (A.P.); (P.G.); (N.N.); (G.K.); (K.P.)
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece; (S.G.); (P.T.); (E.M.); (A.R.); (M.K.)
| | - Nikolaos Nitsos
- Centre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, Greece; (K.S.); (A.P.); (P.G.); (N.N.); (G.K.); (K.P.)
| | - Georgia Kokkali
- Centre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, Greece; (K.S.); (A.P.); (P.G.); (N.N.); (G.K.); (K.P.)
| | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias, 11527 Athens, Greece; (S.G.); (P.T.); (E.M.); (A.R.); (M.K.)
| | - Konstantinos Pantos
- Centre for Human Reproduction, Genesis Athens Clinic, 14–16, Papanikoli, 15232 Athens, Greece; (K.S.); (A.P.); (P.G.); (N.N.); (G.K.); (K.P.)
| |
Collapse
|
3
|
Pantos K, Simopoulou M, Pantou A, Rapani A, Tsioulou P, Nitsos N, Syrkos S, Pappas A, Koutsilieris M, Sfakianoudis K. A Case Series on Natural Conceptions Resulting in Ongoing Pregnancies in Menopausal and Prematurely Menopausal Women Following Platelet-Rich Plasma Treatment. Cell Transplant 2019; 28:1333-1340. [PMID: 31271054 PMCID: PMC6767896 DOI: 10.1177/0963689719859539] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Since the introduction of autologous platelet-rich plasma (PRP) in medical practice, various studies have documented that implementing PRP can enhance healing and the anti-aging process, employing angiogenesis regeneration due to the multiple growth factors and cytokines involved. Numerous reports have shown promising results with the use of PRP in ovarian treatment, regarding ovarian regeneration and reactivation of folliculogenesis. This case series reports on two women with premature ovarian failure (POF) aged 40 and 27 years, respectively, and one menopausal woman aged 46 years. All patients presented with lack of menstrual cycle for over a year. The women reported previous failed in vitro fertilization (IVF) attempts, and, after rejecting the option of oocyte donation, they opted for the approach of autologous ovarian PRP treatment. Following PRP treatment, the three patients were invited to conceive naturally. The primary outcome was the restoration of menstruation following autologous ovarian PRP treatment, as well as an improvement in hormonal profile, a decrease in follicle-stimulating hormone (FSH) levels, and a concurrent increase in anti-Müllerian hormone (AMH) levels. Further to that, our patients achieved pregnancy through natural conception within 2-6 months following PRP treatment, resulting in currently ongoing complication-free clinical pregnancies - a first report in the literature for menopausal and POF patients. Implementation of PRP should be further investigated through randomized controlled trials (RCTs), as it may hold the key to successful treatment for a certain cohort of patients exploring reproductive treatment options following menopause.
Collapse
Affiliation(s)
| | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Agni Pantou
- Centre for Human Reproduction, Genesis Athens Clinic, Greece
| | - Anna Rapani
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Petroula Tsioulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Greece
| | - Nikolaos Nitsos
- Microbiology-Biochemical Department, Genesis Athens Clinic, Greece
| | - Stephen Syrkos
- Centre for Human Reproduction, Genesis Athens Clinic, Greece
| | | | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Greece
| | | |
Collapse
|
4
|
Cabry R, Merviel P, Hazout A, Belloc S, Dalleac A, Copin H, Benkhalifa M. Management of infertility in women over 40. Maturitas 2014; 78:17-21. [PMID: 24679892 DOI: 10.1016/j.maturitas.2014.02.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 02/19/2014] [Accepted: 02/21/2014] [Indexed: 11/16/2022]
Abstract
Women's fertility potential is declining with age because of multiples intrinsic and extrinsic factors such as life style, oxidative stress and/or endocrine disruptors and is affecting the ability of these women to conceive naturally. This declining fertility potential and the late age of motherhood is increasing significantly the number of patients consulting infertility specialists. Different strategies of investigation and management are proposed to patients over 40 in order to overcome their infertility and improve the live birth rate in these patients. Intra Uterine Insemination (IUI) in women over 40 is associated with a low rate of ongoing pregnancy and IUI should not therefore be offered always as the first line of treatment. When the predictive factors are positive IVF/ICSI seem to be good alternatives until 43 years of age. Customized ovarian stimulation and flexible laboratory methods such as in vitro maturation (IVM), preimplantation genetic diagnosis (PGD), embryo vitrification and transfer after thawing in subsequent natural or artificial cycles can improve the success rate of ART in patients over 40. Meanwhile, oocyte and embryos donation remain good options for patient over 40 with a bad prognosis and can lead to successful ongoing pregnancies until 45 years of age. Ovarian tissue cryopreservation, oocyte vitrification at the germinal vesicle (GV) stage or metaphase II stage present a breakthrough for fertility preservation but the ideal age for starting fertility preservation is still debated as well as the minimum number of oocytes to be vitrified in order to optimize the chances of pregnancy when needed at an older age. This manuscript reports the results of our own experience from patients older than 40 in the light of the published data and discusses the different therapeutic alternatives which can be proposed to patients over 40 consulting ART centres.
Collapse
Affiliation(s)
- Rosalie Cabry
- Reproductive Medicine and Medical Cytogenetics Department, Regional University Hospital and School of Medicine, Picardie University Jules Verne, CGO, 124 rue Camille Desmoulins, 80054 Amiens, France.
| | - Philippe Merviel
- Reproductive Medicine and Medical Cytogenetics Department, Regional University Hospital and School of Medicine, Picardie University Jules Verne, CGO, 124 rue Camille Desmoulins, 80054 Amiens, France.
| | - Andre Hazout
- Eylau/Unilabs Laboratory, Reproductive Biology Unit, 55 Rue Saint Didier, 75016 Paris, France.
| | - Stephanie Belloc
- Eylau/Unilabs Laboratory, Reproductive Biology Unit, 55 Rue Saint Didier, 75016 Paris, France.
| | - Alain Dalleac
- Eylau/Unilabs Laboratory, Reproductive Biology Unit, 55 Rue Saint Didier, 75016 Paris, France.
| | - Henri Copin
- Reproductive Medicine and Medical Cytogenetics Department, Regional University Hospital and School of Medicine, Picardie University Jules Verne, CGO, 124 rue Camille Desmoulins, 80054 Amiens, France.
| | - Moncef Benkhalifa
- Reproductive Medicine and Medical Cytogenetics Department, Regional University Hospital and School of Medicine, Picardie University Jules Verne, CGO, 124 rue Camille Desmoulins, 80054 Amiens, France.
| |
Collapse
|
5
|
Fauser BCJM, Devroey P, Diedrich K, Balaban B, Bonduelle M, Delemarre-van de Waal HA, Estella C, Ezcurra D, Geraedts JPM, Howles CM, Lerner-Geva L, Serna J, Wells D. Health outcomes of children born after IVF/ICSI: a review of current expert opinion and literature. Reprod Biomed Online 2013; 28:162-82. [PMID: 24365026 DOI: 10.1016/j.rbmo.2013.10.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 10/03/2013] [Accepted: 10/08/2013] [Indexed: 01/28/2023]
Abstract
The Sixth Evian Annual Reproduction (EVAR) Workshop Group Meeting was held to evaluate the impact of IVF/intracytoplasmic sperm injection on the health of assisted-conception children. Epidemiologists, reproductive endocrinologists, embryologists and geneticists presented data from published literature and ongoing research on the incidence of genetic and epigenetic abnormalities and congenital malformations in assisted-conception versus naturally conceived children to reach a consensus on the reasons for potential differences in outcomes between these two groups. IVF-conceived children have lower birthweights and higher peripheral fat, blood pressure and fasting glucose concentrations than controls. Growth, development and cognitive function in assisted-conception children are similar to controls. The absolute risk of imprinting disorders after assisted reproduction is less than 1%. A direct link between assisted reproduction and health-related outcomes in assisted-conception children could not be established. Women undergoing assisted reproduction are often older, increasing the chances of obtaining abnormal gametes that may cause deviations in outcomes between assisted-conception and naturally conceived children. However, after taking into account these factors, it is not clear to what extent poorer outcomes are due to the assisted reproduction procedures themselves. Large-scale, multicentre, prospective epidemiological studies are needed to investigate this further and to confirm long-term health consequences in assisted-conception children. Assisted reproduction treatment is a general term used to describe methods of achieving pregnancy by artificial means and includes IVF and sperm implantation. The effect of assisted reproduction treatment on the health of children born using these artificial methods is not fully understood. In April 2011, fertility research experts met to give presentations based on research in this area and to look carefully at the evidence for the effects of assisted reproduction treatment on children's health. The purpose of this review was to reach an agreement on whether there are differences in the health of assisted-conception children with naturally conceived children. The researchers discovered no increased risk in birth defects in assisted-conception children compared with naturally conceived children. They found that IVF-conceived children have lower birth weights and higher fat under the skin, higher blood pressure and higher fasting glucose concentrations than naturally conceived children; however, growth, development and cognitive function are similar between groups. A very low risk of disorders of genetic control was observed in assisted-conception children. Overall, there did not appear to be a direct link between assisted reproduction treatment and children's health. The researchers concluded that the cause of some differences in the health of children conceived using assisted reproduction treatment may be due to the age of the woman receiving treatment. Large-scale, research studies are needed to study the long-term health of children conceived using assisted reproduction treatment.
Collapse
Affiliation(s)
- B C J M Fauser
- Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
| | - P Devroey
- Center for Reproductive Medicine, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - K Diedrich
- Department of Obstetrics and Gynecology, University Clinic of Schleswig-Holstein, Campus Luebeck, 23538 Luebeck, Germany
| | - B Balaban
- Assisted Reproduction Unit, American Hospital of Istanbul, Guzelbahce Sokak No 20, Nisantasi, Istanbul 34365, Turkey
| | - M Bonduelle
- Centre for Medical Genetics, Vrije Universiteit Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | | | - C Estella
- Fundación Instituto Valenciano de Infertilidad (FIVI), Valencia University, and Instituto Universitario IVI/INCLIVA, Parc Científic Universitat de València C/Catedrático Agustín Escardino n(o) 9, Edificio 3, 46980 Paterna, Spain; Departamento de Biología Molecular and Centro de Biología Molecular 'Severo Ochoa' (CSIC-UAM), Universidad Autónoma de Madrid, Madrid, Spain
| | - D Ezcurra
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - J P M Geraedts
- Department of Genetics and Cell Biology, Research Institute GROW, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - C M Howles
- Global Development and Medical Unit, Merck Serono SA Geneva, Chemin des Mines 9, 1202 Geneva, Switzerland
| | - L Lerner-Geva
- Woman and Child Health Research Unit, Gertner Institute for Epidemiology and Health Policy Research, Tel Hashomer 52621, Israel
| | - J Serna
- Instituto Valenciano de Infertilidad (IVI) Zaragoza, C/María Zambrano, 31, 50018 Zaragoza, Spain
| | - D Wells
- University of Oxford, Nuffield Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | | |
Collapse
|
6
|
Mokdad C, Clavier B, Perdrix A, Roman H, Marpeau L, Rives N. Facteurs pronostiques en insémination avec sperme de donneur : suivi rétrospectif d’une cohorte de 188 patientes. ACTA ACUST UNITED AC 2013; 41:96-104. [DOI: 10.1016/j.gyobfe.2012.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 06/11/2012] [Indexed: 11/28/2022]
|
7
|
Merviel P, Lourdel E, Cabry R, Brzakowski M, Dupond S, Boulard V, Demailly P, Brasseur F, Copin H, Devaux A. [Intrauterine inseminations in women over 35: the pros]. GYNECOLOGIE, OBSTETRIQUE & FERTILITE 2010; 38:283-9. [PMID: 20362484 DOI: 10.1016/j.gyobfe.2010.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- P Merviel
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU d'Amiens, Amiens, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Stern JE, Brown MB, Luke B, Wantman E, Lederman A, Missmer SA, Hornstein MD. Calculating cumulative live-birth rates from linked cycles of assisted reproductive technology (ART): data from the Massachusetts SART CORS. Fertil Steril 2009; 94:1334-1340. [PMID: 19596309 DOI: 10.1016/j.fertnstert.2009.05.052] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 05/17/2009] [Accepted: 05/28/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine the feasibility of linking assisted reproductive technology (ART) cycles for individual women to compare per-cycle and cumulative live-birth rates. DESIGN Historical cohort study. SETTING Clinic-based data. PATIENT(S) A total of 27,906 ART cycles with residency or treatment in Massachusetts during 2004-2006 and reported to the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) on-line database. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Per-cycle and cumulative live-birth rates. RESULT(S) Linkage of cycles up to and including the first live-birth delivery revealed 14,265 women who averaged 1.9+/-1.2 SD cycles (range 1-11). These cycles yielded 9,452 pregnancies resulting in 7,675 live-birth deliveries. From cycle 1 to cycle 4, the cumulative live-birth rate for all patients increased from 30.4% to 43.3%, 49.1%, and 51.9%, respectively, and plateaued thereafter at about 53%. The cumulative live-birth rate after three cycles using donor oocytes was approximately 60% for women aged<43 years and >50% for women>or=43 years; for autologous oocytes it was 60.1% for ages<35 years and declined steadily to 8.5% for ages>or=43 years. CONCLUSION(S) The results demonstrate the feasibility of linking ART cycles for individual women from SART CORS to characterize cumulative live-birth rates.
Collapse
Affiliation(s)
- Judy E Stern
- Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
| | - Morton B Brown
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Barbara Luke
- Department of Obstetrics, Gynecology, and Reproductive Biology and Department of Epidemiology, Michigan State University, East Lansing, Michigan
| | | | | | - Stacey A Missmer
- Department of Obstetrics and Gynecology, Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, and Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Mark D Hornstein
- Center for Reproductive Medicine, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, Massachusetts
| |
Collapse
|
9
|
Bedaiwy MA, Shokry M, Mousa N, Claessens A, Esfandiari N, Gotleib L, Casper R. Letrozole co-treatment in infertile women 40 years old and older receiving controlled ovarian stimulation and intrauterine insemination. Fertil Steril 2009; 91:2501-7. [DOI: 10.1016/j.fertnstert.2008.03.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2007] [Revised: 02/03/2008] [Accepted: 03/07/2008] [Indexed: 11/16/2022]
|