Platelet-rich plasma: inconclusive evidence of reproductive outcomes in menopausal women

Kheil, Mira; Bahsoun, Reem; Sharara, Fady I.

doi:10.1007/s10815-022-02554-5

Cited by 3 publications

(2 citation statements)

References 30 publications

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“…The pleiotropic nature of PRP adds another investigative dilemma and explains why recommending intraovarian PRP is premature, outside of research settings, for fertility restoration [ 74 , 75 ]. As experience with intraovarian PRP grows, a signature for slowing the pace of reproductive aging is becoming less obscure.…”

Section: Discussionmentioning

confidence: 99%

Multichannel Recovery Potential with Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives

Sills

Wood

2023

Medicines

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Platelet-rich plasma (PRP) is an ‘orthobiologic’ with recognized roles in plastic surgery, musculoskeletal disorders, dentistry, dermatology, and more recently, ‘ovarian rejuvenation’. Intraovarian PRP involves a complex secretome discharged after platelet activation, comprising multiple cytokine mediators delivered surgically to older or inactive ovarian tissue. Loss of oocyte meiotic fidelity and impaired fertilization accompanying advanced maternal age are already managed by IVF, but only with eggs provided by younger donors. However, if the observed effect of rectifying embryo ploidy error can be proven beyond case reports and small series, activated PRP (or its condensed plasma cytokines) would deliver a welcome therapeutic disruption that is difficult to overstate. Because shortcomings in ovarian function are presently addressed mainly by pharmacological approaches (i.e., via recombinant gonadotropins, GnRH analogs, or luteal support), autologous PRP would represent an unusual departure from these interventions. Given the diversity of platelet cargo proteins, the target response of intraovarian PRP is probably not confined to oocytes or follicles. For example, PRP manipulates signal networks driving improved perfusion, HOX regulation, N-glycan post-translational modification, adjustment of voltage-gated ion channels, telomere stabilization, optimization of SIRT3, and ribosome and mitochondria recovery in older oocytes. While multichannel signals operating on various pathways are not unique to reproductive biology, in intraovarian PRP this feature has received little study and may help explain why its standardization has been difficult. Against this background, our report examines the research themes considered most likely to shape clinical practice.

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Section: Discussionmentioning

confidence: 99%

Multichannel Recovery Potential with Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives

Sills

Wood

2023

Medicines

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“…Resumed menses after menopause or deliveries for infertility patients after intraovarian PRP have drawn scrutiny on this experimental procedure. While case reports and small series are encouraging, strong evidence to support its general application is missing ( Kheil et al 2022 ). But to claim the topic is unimportant to women’s reproductive health seems incorrect, as a recent survey of world output on intraovarian PRP research ( Sills & Wood 2021 ) was soon eclipsed by new datasets published from leading centers.…”

Section: Discussionmentioning

confidence: 99%

Epigenetics, ovarian cell plasticity, and platelet-rich plasma: Mechanistic theories

Sills¹,

Wood

2022

Reproduction and Fertility

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Ovarian platelet-rich plasma (PRP) is claimed to restore fertility potential by improving reserve, an effect perhaps mediated epigenetically by platelet-discharged regulatory elements rather than gonadotropin activated G-protein coupled receptors, as with stimulated in vitro fertilization (IVF). The finding that fresh activated platelet releaseate includes factors able to promote developmental signaling networks necessary to enable cell pluripotency tends to support this theory. The mechanistic uncertainty of intraovarian PRP notwithstanding, at least two other major challenges confront this controversial intervention. First is to clarify how perimenopausal ovarian function is reset to levels consistent with ovulation. Perhaps a less obvious secondary problem is to confine this renewal such that any induced recalibration of cellular plasticity is kept within acceptable physiologic bounds. Thus, any ‘drive’ to ovarian rejuvenation must incorporate both accelerator and brake. Ovarian aging may be best viewed as a safeguard against pathologic overgrowth, where senescence operates as an evolved tumor-suppression response. While most ovary cells reach the close of their metabolic lifespan with low risk for hypertrophy, enhanced lysosomal activity and the pro-inflammatory ‘Senescence Associated Secretory Phenotype’ usually offsets this advantage over time. But is recovery of ovarian fitness possible, even if only briefly prior to IVF? Alterations in gap junctions, bio-conductive features, and modulation of gene regulatory networks after PRP use in other tissues are discussed here alongside early data reported from reproductive medicine.

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Regenerative medicine in Obstetrics & Gynecology: Current status under the Act on the Safety of Regenerative Medicine in Japan

Hosoya,

Awano-Kim,

Yokomizo

et al. 2024

Regenerative Therapy

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Platelet-rich plasma: inconclusive evidence of reproductive outcomes in menopausal women

Cited by 3 publications

References 30 publications

Multichannel Recovery Potential with Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives

Multichannel Recovery Potential with Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives

Epigenetics, ovarian cell plasticity, and platelet-rich plasma: Mechanistic theories

Regenerative medicine in Obstetrics & Gynecology: Current status under the Act on the Safety of Regenerative Medicine in Japan

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