Ovarian administration of highly concentrated platelet-enriched plasma/bio-regenerative fibrin.
Infertility caused by impaired gonadal function is particularly challenging to treat since the most effective methods of treatment (IVF with ovarian stimulation) do not produce the desired results. This problem is particularly emphasized by the postponement of reproduction to later life when the aging processes of gonads contribute to less healing success. Young women with oval function retention, as well as women in advanced reproductive years, have a minimal chance of becoming mothers.
Biological therapies are an innovative approach to treatment for all these patients to restore gonadal function and fertility. Biological therapies, based on cells and their products, are used by various cells such as highly concentrated platelets/leukocytes in enriched plasma (hcPRP, PLRP), bio-regenerative platelet-enriched fibrin (BRF) or leukocytes (L-BRF).
hcPRP is a fraction of blood obtained by a special automatised centrifugation process that contains 4 to 8 times the concentration of platelets compared to full blood. Platelets are blood elements that play a fundamental role in blood coagulation and the healing process of injured tissues. They contain numerous growth factors that support cell proliferation, improve vascularization and exhibit an immunomodulatory effect. Bearing in mind that in hcPRP platelets are concentrated multiple times, therefore their effect is much more potent.
Autologous activated hcPRP can be applied alone or in combination with autologous activated BRF, which retains growth factors locally in the tissue and serves as a substrate. These products play an important role in intercellular communication and modulation of the immune response, thus contributing to the regenerative effect, improving ovarian function and regulating hormonal status.
The main indication for these procedures is the failure of the function of the gonads – ovaries. It is always encountered in advanced reproductive years, usually from 40 years old, but largely after 45 years. When this loosening occurs before the age of 40, it is called premature (POI – premature ovarian insufficiency). These patients usually have a very small number of follicles and eggs. A special category in this group is patients with poor response to stimulation during IVF (up to three cells obtained – low response). This technology tries to correct not only the number of cells obtained but also their quality. The problem of cell quality is manifested by the appearance of empty follicles, degenerate cells, lack of fertilization or delay in the development of the embryo.
In stimulating protocols, in addition to injecting hcP(L)RP and BRF, follicle-stimulating, luteinizing hormone (FSH, LH) is used, and sometimes small doses of human choriogonadotropic hormone (hCG). These products play an important role in intercellular communication and modulation of the immune response, thus contributing to the regenerative effect, improving ovarian function and regulating hormonal status. FSH and LH are hormones secreted in our body by the pituitary gland and participate in the regulation of the hormonal reproductive axis. In addition, the exogenous application of FSH and LH is part of standard stimulation protocols within the process of in vitro fertilization. Furthermore, synergistic – cumulative action of ovarian therapy of hcPRP and PRF has been proven, with increased success if given in several consecutive cycles.
The described treatment represents a unique combination of biological therapies and IVF techniques and significantly increases the possibility of obtaining a quality egg cell, which is one of the most important prerequisites for successful fertilization and pregnancy. This procedure is carried out under conditions of analgosedation, under the control of ultrasound. It can be performed separately, and in addition, intraovarian application of hcPRP is one of the procedures within the framework of a single ovarian rejuvenation program - SEGOVA.