Ovarian rejuvenation in Instituto Bernabeu: activation of the ovary with platelet-rich plasma (PRP) from the patient herself and ovarian autotransplantation for regeneration.
New techniques of ovarian rejuvenation allow tissue regeneration to activate the “sleeping” follicles, obtain more eggs and increase the success chances for IVF.
Regenerative medicine is being applied in different therapeutic fields. It is based on the self-healing capacity of the patient, that is, his body uses its own systems, sometimes with external help, to recreate cells and rebuild tissues and organs. Although it is an experimental field, it is beginning to show encouraging results.
The delay of motherhood is a reality in today's society. The ovarian failure or the age are behind many cases of women suffering from low ovarian reserve. Instituto Bernabeu is an international leader in its treatment, with personalized strategies to obtain an extra egg in ovarian stimulation, which can be key to achieving pregnancy.
In 2014 Instituto Bernabeu revolutionized the panorama of assisted reproduction with the application of pharmacogenetics in cases of low ovarian response, which allows applying the most appropriate drug according to the genetic profile of each patient‘s ovary. Subsequently, personalized ovarian stimulation techniques were incorporated, such as luteal phase stimulation, which optimized the response of the patient's ovary to obtain a greater number of eggs, and therefore more embryos.
At present, new strategies are being promoted to solve this group of patients who have residual follicles that remain inactive. And it’s thanks to the studies of new techniques where it acts to "wake up" those follicles that can give rise to a greater number of ovules during the stimulation process of in vitro fertilization. Although a large number of experimental procedures are being evaluated, following a scientific review of the available evidence, Instituto Bernabeu has established those that have demonstrated safety for the patient and show positive clinical results.
OVARIAN REJUVENATION TECHNIQUES
The most effective treatment for this is the intraovarian administration of platelet-rich plasma (PRP) that Instituto Bernabeu is applying successfully in specific cases of patients with poor response and early menopause. For this, the patient's own blood is used, previously prepared in the laboratory. A "spinning" process is performed in which platelets release a large amount of growth factors.
Dr Ana Fuentes, gynecologist at Instituto Bernabeu, explains that the development of follicles in very early stages depends on growth factors, hence administering platelet-rich plasma directly to the ovary can increase the concentration and positively affect what "Wake up." The main objective is to "rejuvenate" or activate the ovary trying to obtain a greater number of eggs.
For the treatment of patients diagnosed with ovarian failure or early menopause, ovarian activation is being carried out using the OFFA technique (Ovarian Fragmentation for Follicular Activation) fragmentation and autotransplantation of the ovarian cortex. It consists of the excision of part of the patient's ovarian cortex obtained after laparoscopy. It is then fractionated and reintroduced back into the ovary. The healing capacity allows activation of residual "sleeping" follicles that are present in patients with ovarian failure, and both spontaneous and in vitro fertilization (IVF) pregnancies have been reported.
So far, these techniques have only shown improvement in certain patients with particular characteristics. There are a series of contraindications to be evaluated, such as the presence of ovarian pathology, the existence of a single ovary, or ovarian failure due to genetic causes or after chemotherapy.
This is why the medical team must assess whether the treatment can be effective in each specific case.
The Instituto Bernabeu group, with clinics in Alicante, Madrid, Mallorca, Albacete, Cartagena, Elche, Benidorm and the international one in Venice, accumulates great experience of success in cases of patients who obtain very few oocytes after ovarian stimulation. The low response ovarian unit is an international pioneer in research and development of strategies in the most difficult cases
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