Revolution in the medical sciences provides a chance to women to revitalize their ovaries by a therapy called ovarian rejuvenation. The therapy offers hope to those patients who have problems like low Oocyte reserve, premature ovarian failure, early menopause problems, and Anti-Mullerian hormone levels.
It is a fact that, a woman is born with millions of Oocyte in her ovaries and as she grows up the egg supply declines in number and in quality as well. It seems quite impossible to develop new eggs in the ovaries naturally. But, according to the recent researches, it is possible to regenerate new eggs with the help of patient’s blood cells. Blood cells have growth factors which help to heal various types of injuries in the body. Growth factors can stimulate the growth of new blood vessels, nerve and connective tissues by the activation of Stem Cells. And stem cells have a power of regeneration.
Ovarian rejuvenation can be done on anytime on women with or without menstruation cycle. The procedure has two steps:
The First step is to isolate the PRP (Platelet-rich plasma), Preparation of PRP begins with the insertion of a needle into the vein in order to get blood in the test tubes. Platelets and White blood cells (WBCs) are separated from the red blood cells (RBCs) and serum by centrifugation process which takes approximately one hour to prepare PRP.
The Second step is Administration of PRP into Ovaries, under an intravenously administered anaesthesia. The isolated PRP (supplied with protein-rich growth factor and stem cell chemoattractants) is injected into the ovaries specifically in the cortical tissue of the patient with the help of transvaginal ultrasound.
Ovarian Rejuvenation has the utmost benefit that it gives a chance to women to become pregnant from her own eggs naturally and also helps in improvement in hormone levels.
After the procedure, it is very important to keep an eye on AMH (anti-Mullerian hormone), FSH, LH and Estradiol levels along with the ovarian function for 1- 3 months. The values will help to know the positive working of ovarian rejuvenation. Usually, the improvement shows up in 1-3 months but in some cases, it takes more than that. So, the monitoring is done up to 6 months. But the treatment is still in research phase. If ovarian rejuvenation treatment shows a promising future, and then it could help many women who have various types of age-related infertility problems.
Ovarian reserve is the number of eggs in the ovaries at a particular time. It is like a jar where few follicles are used every month but you cannot add anything into it.
Intrauterine this pool is 6-7 million , but at time of birth only 1-2 million are left due to autodegeneration. This number further reduces to 2.5-5 lakh at puberty. As the process of selection and degeneration goes on this pool is depleted as we age.
Now what can be cause of low ovarian reserve i.e. the reserve is less than that speculated for age.
These can be –
- Genetic Predisposition.
- Chromosomal anomalies
- Destruction of ovarian reserve by surgery, Endometriosis, other benign or malignant ovarian tumors. Pelvis adhesions,etc.
The best way to diagnosis low ovarian reserve is ultrasonography ( Antral follicle count ) and Anti- Mullerian hormone (AMH).
There are many IVF protocols and treatment modalities which we are using for patients with limited ovarian reserve but these may work in some and not at all in other and for them donor eggs is the next option.