Plasma Rich in Growth Factors (PRGF-ENDORET®) for Ovaries

Plasma Rich in Growth Factors (PRGF-ENDORET®) for Ovaries

Plasma rich in growth factors (hereinafter also PRGF) is a preparation from a sample of the patient’s own blood.

This PRGF is prepared according to the PRGF-Endoret® closed-technique system developed by BTI Biotechnology, and is a biomedical technology aimed at stimulating tissue regeneration through the application of growth factors and other proteins present in blood plasma. The application of Endoret® Technology (PRGF®) is a Medicinal Product for Human.

Platelet growth factors are a set of proteins that are involved in cell communication by modifying biological responses. This type of therapy has been widely used in many fields of medicine and dentistry and is based on Regenerative Medicine; it aims to achieve tissue regeneration by mimicking the body’s own regeneration processes.

Suitability of the treatment in relation to ovarian ageing

Ovarian ageing is a term that describes a wide range of pathophysiological conditions in which ovarian function is compromised. In the context of assisted reproductive treatment, women with severely diminished ovarian reserve may have a poor response to ovarian stimulation treatments, recovering very few oocytes or those recovered being of poor quality.

Considering that success in these treatments depends on having good quality pre-embryos, the reproductive potential of these patients is quite limited.

Therefore, in Reproductive Medicine, intraovarian administration of an activated plasma rich in growth factors is a novel approach that has shown promising results in the context of regenerative medicine, hence it being recommended to improve certain gestation possibilities. At this time, studies have already been published in which restoration of ovarian function has been observed through the administration of this platelet concentrate, with the resulting improvement in the results derived from assisted reproduction treatment, hence its recommendation.

Alternatives to treatment with intraovarian administration of plasma rich in growth factors

Ovarian ageing is a physiological process associated with a decrease in oocyte quantity and quality that has critical implications for fertility and is a major reason in seeking solutions based on assisted reproductive techniques. The wide range of factors that can affect ovarian function, from advanced maternal age to genetic and/or environmental factors, can add a further level of complexity, making efficient management of this characteristic difficult to achieve.

The options currently available include very specific assisted reproduction strategies with own oocytes, which have mixed results. If no results are obtained, gamete donation treatment alternatives and/or adoption can always be used as a last resort.

Procedure

• Firstly, compliance with the inclusion criteria is required for the possibility of undergoing this treatment.
• The blood sample will be processed according to the protocol of the closed-system PRGF-Endoret®.
• Administration of a predetermined volume (ml) of activated plasma rich in growth factors transvaginally, under ultrasound guidance and sedation.
• After the procedure, the patient will remain under observation for 30-40 minutes and she will be discharged on an outpatient basis.
• After the procedure the patient can return to normal life.

Contraindications

There are certain conditions in which it is not advisable to perform intraovarian administration of PRGF due to a possible risk of encouraging or worsening other pathologies:

• Genetic ovarian insufficiency.
• History of malignant ovarian tumour.
• Presence of any pathology that in the medical specialist’s opinion constitutes a risk or contraindication for the patient.
• Patients with reports from specialists advising against pregnancy.

It is important that you inform your doctor of all your medical conditions and any drugs you are taking.

Risks

This instillation is autologous, i.e. it comes from the patient’s own blood, so the patient is not exposed to foreign cellular material that could cause a reaction in her body.

The risks are similar to those of an ovarian puncture as both involve sedation and an oocyte puncture under transvaginal ultrasound guidance; the only difference is that instead of extracting oocyte fluid, a platelet concentrate will be injected. Risks associated with this procedure similar to ovarian puncture include haemorrhage, pelvic organ injury (bladder, bowel or blood vessels, pelvic infection and ovarian torsion).

The risk of complications may be increased in cases of previous abdominal surgery with pelvic adhesions, autoimmune, infectious or endocrine diseases. In all these situations, the medical team will establish the risk/benefit of the procedure and give appropriate recommendations.

In the event that the needle punctures skin and/or mucous membranes, there is a theoretical risk of infection and/or bleeding, but these risks are minimal. Since the procedure is performed under sedation, you will not experience any pain. After the procedure, you will remain under observation for 30-40 minutes when you will be discharged on an outpatient basis.

In addition, the system used is closed, so we do not expect any contamination.

No risks or side effects are described in the literature with this procedure.