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A NEW HOPE FOR A SOLUTION?
A condition that often ties the hands of the couple and the Turkish doctor in IVF treatments and sometimes causes despair of treatment now is that the woman’s ovarian reserve is very reduced and there are difficulties in obtaining healthy eggs and embryos.
The method called PRP, which is suggested to be a partial solution to this problem and to increase the number of eggs obtained, is a method of applying platelet-Rich plasma (Platelet-Rich Plasma) rich in platelets (blood clotting cells) and growth factors to the organ or tissue to be treated and treated. This method has been used for more than 30 years to help tissue repair in branches such as orthopedics, sports medicine and plastic surgery.
In order to apply the PRP method, the blood taken from the patient is first separated by undergoing certain procedures and the platelet-rich plasma portion of the blood is obtained. This resulting plasma is delivered to the target tissue and the process is performed and it is expected to stimulate the precursor cells in the tissue.
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WHAT IS THE PRP METHOD IN IVF?
Studies conducted in the field of IVF show that PRP application can be used in two different ways to increase success. PRP application, also popularly referred to as egg rejuvenation, is most often an attempt to obtain a larger number of eggs during a treatment process by Decongesting the potential of ovarian tissue with these injections. The other is that for problems related to thickening of the inner membrane of the uterus (endometrium), it is given into the uterus for this purpose to ensure sufficient thickness and maturation of the membrane.
If PRP is to be applied inside the uterus, the patient is not given any anesthesia and it is definitely a painless procedure. If an injection is to be made into the ovary, it is performed under anesthesia, just like in the egg collection process, and in this way the patient does not feel any pain.
The studies carried out specifically mention the success in a 2-4 month period after the procedure period.
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IS ANYONE PREGNANT BY THE PRP METHOD? IS SUCCESS REALLY INCREASING?
The first human study on stimulating a woman’s ovaries with PRP and trying to achieve pregnancy was reported at ESHRE (European Society of Reproductive Medicine and Embryology) Congress in 2016. In this study, it was reported that 8 women reported to be in the menopause process achieved follicle development and mature egg production, albeit limited (an average of 1.5 mature egg cells), and the resulting embryos were frozen.
Later, in several studies, some studies have also been published that claim that PRP application provides a numerical increase in egg production and is successful, but controversial in terms of content.
Although it has been reported that pregnancy has been achieved in studies, there is not yet sufficient data that the PRP method provides a statistically significant success in these cases. Similarly, although some improvements were observed individually in the applications in which PRP was given into the uterus in patients with uterine membrane problems, the results that it was statistically successful are controversial.
In order to determine that applications such as PRP are clinically safe and increase success, new medical studies are needed in which there are a large number of women with similar problems, and women who have applied PRP and those who have not are statistically comparable.
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IS THERE A RISK OF PRP APPLICATION?
At the current stage, there are important points that should be seriously considered before using the PRP method to increase the success in IVF treatments.
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HOW SAFE IS THE TECHNIQUE?
Just as the PRP method has not yet had a proven success in the field of reproductive medicine, we also do not have enough data on its possible negative effects and safe use in the tissues and organs where it is applied. Considering its application for the purpose of ”ovarian rejuvenation”, the PRP solution is delivered into the ovaries with the help of a needle passing through the vagina, as in the same egg collection process (OPU). There is a risk similar to the risks associated with the technique of reaching the ovaries with a needle, which is a common procedure in IVF centers. Therefore, like every interventional procedure, this procedure has its own risks, albeit minimal, and it should be monitored whether it creates a significant problem for patient health during and after the application.
This positive effect has been observed within the last 3-4 months after the PRP treatments applied so far. In order to objectively evaluate the effect, AMH and FSH levels are measured during menstruating women and every month in non-menstruating women to monitor whether new eggs are formed in the ovaries after the application. Spontaneous (spontaneous) pregnancies have also been reported in this way. However, since PRP application in IVF is a very new procedure, it is difficult to accurately predict the long-term effect of the treatment. In this context, it is too early to make definite judgments about whether the effect of PRP treatment is an effect that provides an increase in eggs for only a few months or an effect that continues after that.
In the coming period, it will be learned through studies what the real success of this application is.
Prof. Dr.
IVF Center MedicalPark Antalya Hospital
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Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.
Physician's Resume:
Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.
Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.
In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.
Awards:
Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.
Certificates:
Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .
Professional Members:
American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.
Disclaimer:
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