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Researching PRP and Ovarian Rejuvenation in Fertility Treatment

Can platelet-rich plasma (PRP) improve the function of the ovaries? Due to a lack of available clinical evidence, CHR has launched a new study to test the effects of PRP on ovarian function and ovulation.

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Hi, I’m David Barad and you may know that at CHR, for a long time, we’ve had it interests in taking care of women who’ve failed treatment in other places largely because of problems with the way their ovaries are functioning. Some people call this diminished ovarian reserve. Recently, there’s been several approaches to treating women with diminished ovarian reserve and we’ve become interested in trying to test what the validity of those approaches are.

We have been doing a study which we call a PRP for premature ovarian insufficiency and that’s been running for about 6-7 months now. And that’s just for young women who’ve lost their ovarian function before the age of 40. And that study involves using something called PRP, which is platelet-rich plasma. Now others have been using platelet-rich plasma to try to do something which they called “ovarian rejuvenation.” The idea being that you can take ovaries from somebody who’s beyond the normal age of ovarian function (say over forty-five) and treat them and try to resuscitate the ovarian function. And these other places have made some claims that this works, and so here at CHR we decided we want to test that. So since it’s not a proven modality of treatment, we’re doing it within the confines of a study.

And for women who are over the age of 40 and have evidence of poor response to ovulation induction (meaning that they’ve gone through an attempted ovulation induction and produced only one egg or fewer than one egg and they’d like to try to do better), we’re bringing them into this study. And basically what it involves is using this platelet-rich plasma, which is blood taken from the patient herself, spun down, treated in a certain way so that when we bring back the serum it has an increased concentration of platelets in it– namely that “platelet-rich plasma.”

Now the idea of the platelets is that under normal circumstances, platelets help with healing. First they stop the blood flow when you cut yourself, and then they release growth factors that aid healing. And our thought (or actually a thought of the people who are promoting this) is that if we introduce those growth factors to the ovary, that we can improve the function of the ovary.

Now, there’s not much clinical evidence to support that this actually works. There’s anecdotal reports of people who’ve treated women with platelet-rich plasma and it had some response but the problem is especially in the younger ages– say in the early 40s, some women will have irregular menstrual periods, so [they will] be at a point where they’re ovulating maybe two or three times a year. So it’s kind of to sort out when you’re doing this kind of treatment in an uncontrolled fashion, whether the occasional ovulation that allows somebody to retrieve an egg or sometimes even achieve a pregnancy is because of a particular treatment or whether it’s something that might have happened anyway.

What we’re doing in this trial is looking very carefully over the first more-or-less three months after somebody receives platelet-rich plasma to look both at the ovaries with sonograms, and at the blood test to see what happens with your hormones. At first, every three days for the first two weeks and then once a week for about three months, so we can see if there is any solid evidence of any kind of clinical response in a timely way after the PRP treatment. Now, this is not a randomized controlled trial. We’re going to be treating both ovaries in this study that we’re calling “PRP for age,” that meaning that it’s age-related diminished ovarian function.

And our goal in this is to really just try to understand what the ovaries, what changes occur in the ovary, and in hormones that are produced by the ovary. in the first three months after the PRP treatment. If anybody has a response or evidence of a follicle production, you will have the opportunity to go into an IVF cycle, but that would be normal type of IVF cycle and with normal charges associated with it. But, within the study, the PRP treatment itself and the testing we’re doing with the PRP treatment, that’s part of the study.

So, there are criteria for being in it, obviously one needs to have evidence of diminished ovarian function, meaning failure to respond in a previous cycle– either no response or only one egg. We’re not treating anybody over the age of 53. I think that’s appropriate. We need to be able to have access to you to do the monitoring over the three months after the treatment, and you of course need to be able to come to CHR to have the treatment. There are some other health related issues, for instance, you can’t be taking aspirin for two weeks before you have the PRP treatment because aspirin decreases platelet activity. You can’t have some conditions that are associated with problems with platelets, and we of course would review those with you if you contact us to discuss participating in this trial.

So if you’re interested, please contact us and I’ll be happy to discuss this with you further.