Ovarian PRP: A Glimpse into the Future of Infertility Care

Updated: 5 days ago

In the realm of human reproduction and reproductive health, infertility represents a significant challenge, affecting approximately one in eight couples in the United States. This condition is characterized by the inability to achieve pregnancy following twelve months of regular, unprotected intercourse. The implications of infertility extend beyond the biological incapacity to conceive, encompassing a spectrum of psychological distress, economic burdens, and profound implications for personal and familial aspirations.

Within this context, platelet-rich plasma (PRP) therapy for ovarian function presents an area of emerging interest. This therapeutic approach involves the injection of a concentration of platelet-rich plasma, derived from the patient's own blood, into the ovarian tissue. The premise of this treatment is based on the potential properties of growth factors and cytokines present in platelets to stimulate ovarian follicular development or enhance the ovarian microenvironment, thereby potentially improving ovarian function and fertility outcomes.

Impacts of Infertility

Infertility encompasses a broad spectrum of challenges that transcend the boundaries of medical concerns, touching upon various facets of life and the process of human reproduction.

Emotional Toll

Infertility is frequently accompanied by a complex array of emotions, encompassing hope, disappointment, frustration, and sadness. Such emotional volatility can markedly affect one's psychological health, potentially precipitating conditions such as stress, anxiety, and depressive disorders. Moreover, those grappling with infertility often endure a distinctive grieving process, mourning the absence of a prospective future that remains uncertain. This form of profound and deeply personal grief may lead to a sense of isolation that is exacerbated by societal stigmas and misconceptions surrounding infertility. Consequently, individuals may experience feelings of shame and a reluctance to share their experiences, further compounding their sense of isolation.

Additionally, the emotional turmoil associated with infertility can exert significant strain on relationships. Variations in the manner in which partners process these emotions can give rise to communication difficulties, tensions, and misunderstandings, challenging the resilience and dynamics of relationships. This strain, coupled with the societal stigma and personal grief associated with infertility, contributes to a multifaceted challenge that affects individuals and couples not only emotionally but also in their social interactions and relationships.

Acknowledging and understanding these complex emotional and social impacts is crucial to the medical and supportive care of individuals navigating the path of infertility. [1] [2] [3]

Financial Burden

The cumulative costs of infertility treatments, especially when multiple cycles are required, can impose a substantial economic strain. The aggregate expenses of such treatments, inclusive of medications and ancillary procedures, are notable and often incurred without a guarantee of successful pregnancy outcomes.

Furthermore, the pursuit of infertility treatments introduces complexities in managing professional responsibilities. The necessity for frequent medical appointments, along with the physical and emotional toll of treatments, can significantly disrupt employment routines and productivity. [4] [5] [6]

Understanding Ovarian Platelet Rich Plasma

Platelet-rich plasma therapy is a technique that utilizes the platelets from the patient's own blood, which are components known for their role in clot formation and healing processes. The essence of PRP therapy lies in the concentration and application of these platelets, which are rich in growth factors, to specific areas of the body—in this case, the ovaries.

The process of obtaining PRP begins with a standard blood draw. After collecting the blood sample into a specialized tube, it's placed in a centrifuge, where a machine spins the blood at high speeds to separate the platelets from other components of the blood. The concentration of platelets obtained is then prepared for therapeutic use.

For ovarian health, the prepared platelet-rich plasma is injected directly into the ovarian tissue. This direct application strategy is designed to target ovarian tissue issues at their source, enhancing the potential for improved fertility. [7] [8]

The utilization of PRP therapy in ovarian treatment is predicated on a number of proposed biological mechanisms that aim to enhance fertility through ovarian stimulation. Firstly, it is suggested that PRP therapy can significantly increase blood flow to the ovaries. This augmented circulation is believed to enhance the supply of essential nutrients and factors necessary for healing to the ovarian tissues, potentially improving their functionality, which is a cornerstone for fertility. [9]

Moreover, an additional mechanism by which PRP therapy may exert its effects is through the stimulation of stem cells in the targeted ovarian area. Stem cells are pivotal to the body's natural repair processes, and their activation through PRP therapy could be instrumental in improving ovarian tissue health, thereby potentially augmenting ovarian function and enhancing fertility prospects. [10]

A further aspect of PRP therapy's potential impact involves the endometrial lining. The therapy is theorized to positively influence the endometrium, improving its receptivity and condition, which is vital for embryo implantation. A healthy and receptive endometrial lining is a critical factor for achieving a successful pregnancy, addressing an essential component of fertility challenges. [11]

Comparison with Traditional Infertility Treatments

The initial step in addressing infertility often involves ovulation-induction medications, such as clomiphene citrate and gonadotropins, designed to stimulate the ovaries to produce eggs. The cost of these medications can range from relatively affordable to more expensive, depending on the type and duration of fertility treatment used. Although generally less expensive than more invasive procedures, their effectiveness is contingent upon various factors, including age, specific fertility issues, and overall health. It may be necessary to undergo multiple cycles, increasing both financial and emotional costs. [12]

Intrauterine insemination (IUI) represents a more direct approach than medication alone, involving the placement of sperm directly into the uterus during ovulation to improve fertilization chances. Suited for cases of mild male infertility or unexplained infertility, IUI costs fall between ovulation-inducing medications and more advanced treatments like in vitro fertilization (IVF), with its success influenced by the use of fertility drugs, patient age, and underlying infertility causes. [13]

IVF treatment stands as a highly effective yet costly option, encompassing egg stimulation, retrieval, fertilization in a laboratory, and embryo implantation. The comprehensive nature of IVF requires a significant financial outlay, covering medication, procedures, and lab work, but offers higher success rates, especially for complex infertility cases. Success varies with factors such as maternal age, specific causes of infertility, and lifestyle. [14]

Amid traditional treatments like ovulation induction, IUI, and IVF, the emergence of platelet therapies, including ovarian PRP and penile PRP injections, presents novel fertility treatment avenues. These options expand the array of solutions available to individuals and couples navigating the path to parenthood, reflecting the dynamic and varied landscape of fertility care.

FAQs

When evaluating platelet-rich plasma (PRP) therapy for infertility within a clinical setting, healthcare professionals may have inquiries regarding its application, efficacy, and patient suitability. The following information is designed to address these considerations, with a focus on providing a comprehensive understanding for healthcare providers.

Is PRP therapy for infertility safe?

PRP therapy, utilizing autologous blood components, is generally considered to have a favorable safety profile. The procedure involves extracting a blood sample from the patient, processing it to enrich the platelet concentration, and subsequently administering the PRP to the patient.

This closed-loop process minimizes the risk of adverse immunological reactions or the transmission of infectious diseases. However, healthcare providers should be aware of the procedural risks, including potential infection at the injection site, and discuss these with patients as part of informed consent.

Is PRP therapy for infertility painful?

The procedure for PRP therapy involves discomfort primarily associated with the initial blood draw and the subsequent injection of PRP. This discomfort is typically described as minimal and comparable to other routine injections. The application of local anesthetics can mitigate discomfort during the first PRP injection administration. Healthcare providers should counsel patients on what to expect during the procedure and manage pain accordingly.

How much does ovarian PRP therapy cost?

The cost of ovarian PRP therapy can vary widely based on geographic location, the specific protocol employed, and the number of treatment cycles. Given the personalized nature of the therapy and its relative novelty, expenses can be significant and may not be covered by traditional insurance plans. Healthcare providers should provide patients with a detailed breakdown of expected costs and discuss financial planning for treatment.

How long do the effects of ovarian PRP last?

The duration of the therapeutic effects of ovarian PRP therapy is variable among individuals. Factors influencing the longevity of treatment benefits include the patient's unique response to therapy and their underlying fertility issues. Some patients may observe long-term improvements, while others may require subsequent treatments. It is important for healthcare providers to set realistic expectations based on individual patient profiles and available evidence.

Who is a good candidate for PRP for infertility?

PRP therapy for infertility may be considered for a broad spectrum of patients, including those who have not responded to traditional fertility treatments or are seeking alternative options. Eligibility for PRP therapy should be determined based on a comprehensive assessment of the patient's age, health status, and specific fertility challenges.

Healthcare providers should conduct a thorough evaluation to ascertain the appropriateness of PRP therapy for each patient, considering both the potential benefits and limitations of this treatment modality.

Potential Limitations and Risks

While ovarian PRP therapy holds promise as a potential avenue for addressing fertility challenges, it’s imperative to critically assess the current limitations and associated risks of this emerging therapeutic approach. A comprehensive understanding of these factors is essential for guiding patients through informed decision-making processes regarding ovarian PRP therapy.

1. Limited Clinical Evidence

The domain of ovarian PRP therapy is marked by its novelty, with a corresponding scarcity of extensive, long-term clinical evidence. The efficacy, potential adverse effects, and identification of optimal patient candidates remain areas of ongoing investigation.

Variability in patient outcomes is notable, influenced by factors including age, health status, and specific fertility issues. This heterogeneity underscores the necessity for healthcare providers to remain abreast of the latest research findings and to communicate the current state of knowledge transparently to patients.

2. FDA Approval

While the equipment utilized in the preparation of PRP and the injection procedures themselves have received clearance from the U.S. Food and Drug Administration (FDA), the use of PRP therapy, particularly for infertility treatment, remains investigational and has not been formally approved by the FDA for this indication. It's noteworthy that the PRP treatment, being a product derived from an individual's own blood, is not classified as a drug.

This distinction is significant because FDA clearance for the equipment and procedure allows healthcare professionals the discretion to utilize PRP therapy if deemed in the best interest of the patient, despite the lack of specific approval for certain applications, including infertility. [15]

Given this context, healthcare professionals are encouraged to navigate the evolving landscape of fertility treatment options with a comprehensive and evidence-informed perspective. When considering PRP therapy for infertility, practitioners need to weigh the promising aspects of PRP research against its current investigational status for this specific use.

3. Potential for Adverse Reactions

Despite the autologous nature of ovarian PRP therapy, which utilizes the patient's own blood components, there remains a spectrum of potential adverse reactions. These may range from localized pain or discomfort at the site of injection to the risk of infection and other complications. It is incumbent upon healthcare providers to discuss these potential risks thoroughly with patients, ensuring a clear understanding of the safety profile of ovarian PRP therapy.

SELPHYL® Disclaimer

Instructions for the use of SELPHYL® can be found here and here.

SELPHYL® has not been approved by the FDA for subcutaneous, submucous, or intradermal injections in aesthetic medicine, and the safety and effectiveness of SELPHYL® for these conditions have not been established.

SELPHYL® is designed to be used for the safe and rapid preparation of autologous platelet-rich plasma (PRP) from a small sample of peripheral blood at the patient's point of care. The PRP is mixed with autograft and/or allograft bone prior to application to a boney defect to improve handling characteristics.

As of the time of writing, SELPHYL® has no known serious, life-threatening, or fatal risks apart from the adverse reactions described above.

SELPHYL® Limitations, Restrictions, Cautions, and Warnings

Prescription only.
Do not use the kit if the sterile packaging is damaged or compromised.
Follow universal safety precautions for blood collection and sharps disposal.
During blood draw, failure to align and properly seat tubes in the tube holder can result

in a loss of vacuum and a loss of blood draw.

During PRP transfer, failure to align and securely seat tubes simultaneously in

assembled blood transfer device tube holders can result in a loss of vacuum and the

failure of PRP to transfer to the red-top PRFM tube.

Do not initiate the transfer of PRP into the red-top PRFM tube until the physician is

ready to complete the procedure.

Do not reuse.

SELPHYL® Contraindications

These are not in FDA-required labeling and are part of SELPHYL®’s clinical evaluation for EU CE requirements.

Direct connection to a patient’s vascular system of circulating blood volume.
Other health conditions and diseases may also contraindicate the use of autologous

PRP, including but not limited to low platelet count, sepsis, localized infection in the

treatment area, anemia, malignancy with hematologic or bony involvement, and

anticoagulation therapy.

Takeaway

Ovarian PRP therapy is currently under investigation as a potential treatment within the domain of infertility care. This innovative approach leverages autologous blood components with the intent of improving ovarian function.

For healthcare professionals, the integration of ovarian PRP therapy into fertility care protocols requires a balanced consideration of its investigational status, potential benefits, and limitations in comparison to established treatments. Financial considerations and the variable efficacy of ovarian PRP therapy necessitate a personalized evaluation of its role in each patient's treatment plan.

Within the spectrum of available fertility treatments—including ovulation induction agents, IUI, and IVF—ovarian PRP therapy emerges as an additional option, enriching the array of therapeutic strategies with its unique mechanism of action.

About the Author

Dr. Ali is a medical journalist and copywriter employed by SELPHYL® for the writing of this article.