Ovarian Structure Regeneration
One of the major challenges for modern reproductive medicine is the treatment of infertility in patients with reduced or depleted ovarian reserve. The problem is that there are no effective therapies to increase ovarian activity in this group of patients, and egg donation is considered to be the only proven treatment approach. Today, however, we can see important progress in the development of reproductive capacity storage methods in women, which include cryopreservation of eggs, embryos, and ovarian tissue. In addition, mention should be made of new methods, known as in vitro activation of dormant follicles, as well as the use of stem cells to regenerate ovarian structures.
They are based on specific methods of stem cell extraction and/or active substances and growth factors from the patient's circulatory system. This approach has a positive effect on fibrosis – a hallmark of an aging ovary.
The treatment induces an activation of angiogenesis, inflammation control, an increase of anabolism, cell migration, differentiation and proliferation, and limits the processes of programmed cell death (apoptosis).
The method was developed by a team of researchers at Harvard University who injected mouse ovaries with growth factors, which resulted in mature ovaries forming from ovarian stem cells.
In the clinical practice, this innovative therapy is usually offered to patients with reduced or depleted ovarian reserve and to women aged 43 years who wish to become pregnant using their own eggs. This treatment is also recommended in cases with a series of unsuccessful in vitro procedures in which pregnancy with the patient's own eggs is not achieved. If ovarian regeneration therapy is successful, the patient may become pregnant naturally or using other infertility treatment methods, such as intrauterine insemination or in vitro technology.
What does the treatment entail?
Before the procedure for the regeneration of the function of the ovarian structures is planned, the patient undergoes the necessary gynecological and hormonal examinations. The ovarian reserve is determined based on a set of criteria. What follows is the planning and implementation of the procedure for a specific treatment algorithm. An appointment is assigned for the manipulation. Before it can commence, a blood sample is taken from the patient. It takes between 2 and 4 hours to process. Consequently, an injection of isolated and activated growth factors into the cortical structures of the ovarian tissue is carried out.
This is done with anesthesia and under ultrasound. The effect of the procedure is established 6-12 weeks later and lasts 5 to 8 months. The first symptoms of exposure are expressed in the regulation of the menstrual cycle, increase in sexual drive and activity, and improvement of the quality of eggs and embryos established during an in vitro procedure.
The results of studies show that after the application of the ovarian regeneration procedure, the success of the method (expressed in childbirth) depends on the condition of the ovary and the age of the patient, respectively in women with poor ovarian response the success rate is about 27%, women with premature failure ovarian function - 10%, perimenopausal women - 17% and menopausal women - 3%.
Contraindications to the administration of this treatment have not been established, and the risks are minimal and similar to those of an in vitro procedure.
The endometrium plays an important role in achieving optimum results in assisted reproductive technologies. Studies have shown that insufficient endometrial growth during ovarian stimulation leads to poor results in in vitro treatment. For this reason, different approaches are applied to improve endometrial thickness. One is based on the extraction of stem cells and / or active substances and growth factors from the patient's circulatory system, which are injected into the uterine lining after treatment and activation.
This method has been successfully applied to women with a history of a series of unsuccessful in vitro procedures, thin endometrium, and those with a history of chronic endometritis.
What does the treatment entail?
Before planning the procedure for the regeneration of the uterine lining, the patient undergoes the necessary gynecological examinations. An appointment is assigned for the manipulation. A blood probe is taken beforehand, which requires between 1 and 2 hours to be processed. What follows is the injection of isolated and activated growth factors into the endometrium. The procedure is painless and does not require anesthesia. The effect of treatment is achieved after 1-3 procedures. Studies have shown that this treatment approach significantly improves the chance of pregnancy, with results comparable to those in which the lining of the uterus has normal parameters.