The use of platelet-rich plasma (PRP) is a procedure that has been widely used in medicine for many years, particularly by orthopedics to treat chronic erosive conditions such as chronic arthritis or to enhance the healing of a wound in cosmetic procedures. In 2006 it was successfully used in a case of ovarian tissue transplantation by a group of Italian gynecologists in order to enhance the blood circulation and re-function of the engrafted transplant.
Our group was the first internationally to apply this technique to menopausal and perimenopausal women as well as poor hormonal responders with particularly encouraging results regarding the reactivation of the ovaries and the results were announced for the first time internationally at the Pan-European Conference of the European Society for Reproductive Medicine in Helsinki in 2016 https://www.eshre.eu/
The announcement created such a special impression and excitement and the news that we could now delay the aging of the ovaries literally went around the world. https://www.newscientist.com/article/mg23130833-100-menopause-reversal- restores-periods-and-produces-fertile-eggs/
Since then, hundreds of IVF specialist groups and centers around the world have been applying it with similar results and it is now a promising protocol for rejuvenating the ovaries and the endometrium in cases of chronic endometritis.
The beneficial effects of the method seem to be mediated by platelet growth factors which are secreted in order to promote angiogenesis, epithelization and cell differentiation as well as the production of extracellular substance and the proliferation of endothelial cells, fibroblasts, and ovarian stromal cells tissue as well as endometrial tissue.
The procedure is very simple and the protocol involves the collection of a small amount of blood from the patient which is then centrifuged for a few minutes. The resulting plasma is collected and activated using calcium gluconate. The solution produced is then injected into the ovaries under anesthesia either through ultrasound or laparoscopic guidance. The reinforcement of the ovarian function is established in the next 6 to 12 months and is evaluated by the improvement of hormonal indicators and egg quality, the facilitation of egg fertilization and the eggs’ division at the desired developmental stage.
Thankfully, the achievement of egg quality improvement occurs in one third of patients and the investigation of the parameters could improve the method’s success is the subject of a major research effort of our team since 2022.
