Regenerative and Aesthetic Gynecology
Stem cell research and regenerative medicine are integral to the field of Obstetrics and Gynecology. Recent years have seen the blooming of regenerative medicine with the shift from the traditional approach of treatment to using the body’s own cells and substances to enhance healing. In this context, platelet-rich plasma has been widely investigated and has played a protagonistic role in many clinical applications.
The clinical use of platelet-rich plasma (PRP) is based on the increase in the concentration of growth factors and in the secretion of proteins which are able to maximize the healing process at the cellular level. Since PRP is an autologous biologic material, it involves a minimum risk of immune reactions and transmission of infectious and contagious diseases, and it has been widely used for the recovery of musculoskeletal lesions. Despite the great potential for applicability, the implementation of the therapeutic employment of PRP as a clinical alternative has become difficult, due to the lack of studies related to the standardization of the techniques and/or insufficient description of the adopted procedures. Therefore, it is required establish standard criteria to be followed for obtaining a PRP of high quality, as well as a larger number of studies which should establish the proper concentration of platelets for the different clinical . Recent data revealed a significant rise in the mean age of first-time mothers, ranging between the third and fourth decade. This is associated with ovarian aging, which is a physiological process characterized by declining oocyte quantity and quality—an unsolved problem in reproductive medicine. Premature ovarian insufficiency (POI), a condition characterized by a premature decline of ovarian function occurring before the age of 40, has risen from 1% to nearly 2% in the last few decades. These changes placed a requirement of implementation therapeutic strategies for these low prognostic infertile women.
In reproductive medicine, PRP was first used to enhance endometrial thickness in patients attempting in vitro fertilization (IVF) treatment.
Numerous published data demonstrated that early follicle development was regulated by intraovarian growth factors through autocrine or paracrine mechanisms.
Several subsequent reports revealed that intraovarian injection of PRP promoted the follicle growth and improved the treatment outcome in poor prognostic infertile women, resulting in several live births without complications.
Furthermore, a large population prospective cohort studies are mandatory to investigate how ovarian injection of PRP with or without Gonadotropins or Stemmcels can trigger the restoration of ovarian function and whether that can be a potential new mode of treatment.