By Chioma Obinna
The desire to have a baby is the most exciting thing in the world and failure to conceive remains a major cause of depression in childless couples.
Thanks to advancement in science that is currently giving opportunity to the 180 million couples suffering from secondary infertility in developing countries, according to the World Health Organisation, WHO. Today, scientists have come up with different techniques to help infertile women. Good Health Weekly spoke to Dr. Jean Nassar, an In-vitro Fertilisation, IVF, Obstetrics and Gynaecology Specialist with 18 years of experience on ovarian rejuvenation, a latest technique that helps women achieve pregnancy.
Nassar, a renowned fertility specialist at One Wellness Centre, Lagos, said while infertility can be a difficult journey, miracles do happen. Nassar who is also the Head of the IVF unit at St. Georges Hospital University Medical Centre in Lebanon explained that ovarian rejuvenation is ideal for women with decreased ovarian reserve based on or early menopause and women who have experienced recurrent failed IVF cycles because of reduced quality eggs.
Ovarian rejuvenation is the latest technique that aims to improve the function of the ovaries in women by injecting platelet-rich plasma (PRP) into the ovaries. The procedure involves extracting blood from the patient; that’s why it is a safe procedure.
The concept behind ovarian rejuvenation is to stimulate follicle growth by stimulating growth of dormant follicles in the ovary and promoting the development of new eggs. Adding to that, by injecting PRP in ovaries, it promotes the formation of new blood vessels; so it improves the overall function of the ovaries, including hormone production and ovulatory capacity.
This, in turn, may increase the chances of successful fertilisation spontaneously or by in vitro fertilisation.
The goal of PRP is to improve fertility and restore ovarian function. So, every woman who has decreased ovarian reserve based on her age or she is experiencing early menopause is a candidate for ovarian PRP. Also, those who have experienced recurrent failed IVF cycles because of reduced quality eggs are candidates for ovarian rejuvenation.
Based on consultation with a specialist, he will decide if she is a candidate of ovarian PRP. This procedure is done under light anesthesia; so the patient will be asked to stay fasting at the same day of procedure. Her blood will be collected. This blood sample will be processed with a specific protocol to separate the platelets and growth factors from other components resulting in a concentrated PRP solution. Using ultrasound guidance, a thin needle is inserted into the ovarian tissue. The concentrated PRP solution is then slowly injected into the ovaries. The ultrasound helps guide the needle to the precise location within the ovaries.
Since ovarian PRP is performed using patient’s own blood, no side effects are linked to it. It is considered a safe procedure. The only side effect that might be experienced for some women is discomfort at the injection site; it will typically resolve within 48 hours. Pain killer is advised to be taken in this case.
Ovarian rejuvenation and in vitro fertilisation, IVF are two distinct fertility treatments with two different methods aiming for the same goal: achieving pregnancy. Ovarian rejuvenation is still a new technique under studies that aims to improve ovarian function; it might be done for trying to achieve pregnancy spontaneously or by IVF. It is case by case decision. IVF is a widely-used assisted reproductive technology that involves fertilising eggs and sperm in the laboratory subsequently transferring embryos inside the uterus.
The success rates of ovarian rejuvenation are still being evaluated, and the evidence is limited. The effectiveness of the treatment in improving fertility outcomes is not yet well-established because this technique is still newly practiced in the ovarian tissue. But it has promising results even in my own practice here in Nigeria. It is important to shed light on its safety for the patient even if it is still under research because it is performed with the patient’s own blood.
Generally, ovarian rejuvenation doesn’t have an age limit. Although it is important to mention that the response is based on the patient’s age. So, it is better to be performed up to 50 years’ old patients after evaluating the patient of course. I will not recommend it for a patient after 50; I would rather recommend egg donation, which would be a better option in this case.
Nowadays, different treatments are available for infertility. It depends on the case and mainly the reason behind infertility. First, the couple should consult a specialist. After doing all the tests required, the specialist will advise the treatment suitable for the couple. For example, Intracytoplasmic Sperm Injection ICSI is the most used technique worldwide; it is based on injecting one competent sperm inside the cytoplasm of the egg and by that we are pushing the fertilisation to occur. Other than ICSI, there are a lot of treatments available like classical IVF, intrauterine insemination IUI, gamete donation, surrogacy, cryopreservation and pregenetic diagnosis PGD.
Nigeria and globally
Definitely, it is acceptable and especially here in Nigeria. I realised during my practice here that couples seek help for infertility issues after 40s. Subsequently, ovarian PRP could be one of the treatments advised by the doctor due to her safety for the patient and it is a minimally invasive procedure; the patient can continue her daily activities directly. In addition, the couple can try to conceive spontaneously in the meantime while doing PRP sessions.
A healthy lifestyle helps improve egg quality and, by that, I mean normal BMI, exercise frequently, avoiding smoking and alcohol and reduce stress. On top of that, the patient will be advised to take some specific vitamins to help us improve the quality of eggs.
Ovarian rejuvenation and other treatments
The goal of ovarian rejuvenation is achieving pregnancy. In some cases, patients achieved their pregnancy spontaneously right after ovarian PRP. In other cases, it might be done in parallel with an IVF/ICSI. In this case, ovarian PRP improves the quantity and the quality of the eggs, and ICSI will be done subsequently.
Factors that may affect outcome
While ovarian PRP is still under investigation, several factors may potentially affect its success. Generally, younger women have a higher chance to get better results. Of course, this procedure should be performed by a skilled professional physician who has a deep understanding of the procedure and its intricacies are more likely to achieve better outcomes. On top of that, each woman’s response can be highly individual. Factors such as genetic predisposition, hormonal balance, and the specific condition being addressed may vary among individuals, impacting the success of the procedure.
Every procedure at One Wellness Centre starts with a consultation with the physician and especially ovarian rejuvenation. The patient must come for a consultation first. Based on her history, age, hormonal status, ultrasound and her intension, a tailored plan will be recommended after discussion with the specialist.
Message of hope
For those who are still battling with infertility, I want to tell them that infertility can be a difficult journey but remember that miracles do happen. The first step to make your dream come true is by seeking help as earlier as possible.
Maintain honest communication with your doctor. Share your feelings, fears, and hopes so he can help you to be on the right track. If conventional methods haven’t provided the desired results, consider exploring alternative paths to parenthood. Options such as adoption, surrogacy, or fertility treatments like IVF may offer alternative paths to starting or expanding your family. Remember, you are not alone. every journey is unique, and there is no one-size-fits-all solution. Stay positive and be patient, you can overcome the challenges and achieve your dreams.