Gen 5 Fertility Center

Ovarian Rejuvenation

How Ovarian REjuvenation Works

The World's First and Only Fertility Center offering Generation 4 Ovarian Rejuvenation Therapy.

Gen 5 Fertility (G5F) was the first and is still the only IVF clinic in the United States (and, of course, the only one in San Diego) to focus on therapeutic and research applications for Platelet Rich Plasma (PRP), Enriched Platelet Factors (EPF) including EnPLAF, ULTRA, and the ULTIMATE, all human Ovarian Rejuvenation procedures.

Now See Exactly How Ovarian Rejuvenation Works.

The video below demonstrates the first three Ovarian Rejuvenation procedures: autologous PRP (Platelet Rich Plasma), EPF (Enriched Platelet Factors) including EnPLAF, and ULTRA, the most advanced ovarian injection of its kind and one offered nowhere else. All are used to improve poor human ovarian function and ovarian insufficiency resulting from ovarian aging. Specific details about each are found in this animation.

Gen 5 Fertility Is Leading The Change by Offering the Most Advanced Intra-ovarian Injections

And Gen 5 Fertility Center is directed by Dr. Samuel Wood, one of the leading fertility specialists in the world. He has helped patients from all continents have the baby they desire. Dr. Wood is a board-certified Reproductive Endocrinologist and world-renowned Fertility Specialist as well as an expert in Reproductive Genetics with over 25 years of clinical experience.  More on Dr Samuel Wood M.D, Ph.D.

Third and Fourth Generation Ovarian Rejuvenation

Hundreds of patients have done Ovarian Rejuvenation with Gen 5 Fertility Center physicians.  Generation 3 was developed using advanced new techniques and it works for a variable percentage of women with diminished ovarian reserve depending on their individual characteristics. We have published multiple research papers based on clinical studies giving details of the Ovarian Rejuvenation procedure and its effects. It is a near-painless procedure for virtually all women and so it almost never requires any anesthesia. It is a safe and affordable technique that gives women who have suffered for so long a chance for success. Generation 4 Ovarian Rejuvenation is our latest treatment strategy and is specifically designed for women who are reproductively older, those with very low levels of AMH, and those with no or very low Antral Follicle Count (AFC). Although most of our work focuses on aging and rejuvenation and our work to improve success rates, other study designs stress other benefits of attempting to restore ovarian function.  Soon, much more information about this groundbreaking technique will be available.

PRP (Platelet Rich Plasma) Solutions

We offer this as an enhancement of the original PRP protocol pioneered in Greece. It is a quite safe and relatively new procedure in which platelets, platelet-derived growth factors or both are placed inside the ovaries in the areas that typically contain eggs. This is achieved by a near-painless injection through the top of the vagina under direct ultrasound guidance. Only very rarely is anesthesia required.

If the ovarian response is improved, then In addition to other ways these techniques might be helpful, Ovarian Rejuvenation may ovarian function by stimulating ovarian stem cells so that they develop into eggs. If the number and/or quality of the oocytes (eggs) available for IVF is improved, the chance of pregnancy may also be improved and the need for donor eggs reduced.

Members of our team worked on the first registered “Ovarian Rejuvenation” human research study in the United States, as listed with ClinicalTrials.gov. To date, our group has safely completed hundreds of ovarian PRP injections using established methodologies, including some with precision laboratory support from speciality laboratories.

Because ovarian PRP and Enriched Platelet Factor infusions involve the use of a patient’s own platelets, rather than donor platelets, there is no risk of cell rejection or graft-versus-host reaction. The procedure is almost always well tolerated and there have been no adverse events or complications associated with either of these procedures as performed using our proprietary method, one used by no other fertility specialist in the world.

Below we answer many of the questions we have received about this revolutionary technology from patients throughout the world. 

We know how tough infertility is.

If you are trying to become pregnant and feel it may be impossible because you have been told: 

  • you are “too old”
  • your AMH is “too low”
  • your FSH is “too high” or your eggs are of “low or poor quality”
  • you “don’t make enough” eggs
  • that all of “your embryos are abnormal”

We may have the perfect solution for you, one you won’t be able to find elsewhere in the world!

Ovarian Rejuvenation Generations 1 through 4!

Ovarian Rejuvenation FAQs.

If you’ve read everything on this page, you will probably know more than most people do (including doctors) about ovarian PRP, Enriched Platelet Factors (like EnPLAF), ULTRA and ULTIMATE. Nevertheless, you likely still have some questions about these procedures. We are always available to help address your questions by telephone well in advance of any personal consult. Just call our office at +1 858-267-4365 and one of our Ovarian Rejuvenation specialists will be happy to speak with you.

First, we draw blood from you. We then process that blood to isolate the platelets. Prior to each procedure, your vagina is prepared for the injections. In the case of the Ovarian Rejuvenation with PRP, the platelets are “activated” which causes them to begin releasing several growth factors. Using a vaginal ultrasound, the ovaries are identified, and activated PRP is injected into each accessible ovary in a special way. In the case of the Ovarian Rejuvenation with EnPLAF (EPF) procedure, the platelets are held in an incubator while they release the growth factors into the fluid around them. This fluid, now filled with growth factors, is then injected into each accessible ovary, again using a special technique. With ULTRA, a proprietary method is used to combine activated platelets (PRP) along with the growth factors obtained from EnPLAF (EPF) to create a powerful combination of these two procedures. This combined solution is injected simultaneously in a near painless procedure.


Specimen processing and ovarian injection requires about 45-60 minutes to complete for PRP, around 2.5 hours for EnPLAF (EPF) and 3 hours for ULTRA. As noted above, it is almost always performed without anesthesia. The goal of treatment with PRP, with EnPLAF and with ULTRA is to improve (“rejuvenate”) ovarian function, primarily by fostering the development of more high-quality oocytes. When this succeeds, your hormonal profile will change and additional follicles will appear to be developing in ovaries previously considered dormant.

Any infertile woman that is concerned that she does not have enough eggs or will have eggs that are not of sufficient high quality should consider Ovarian Rejuvenation (OR). This includes both those that plan to do IVF (in Vitro Fertilization) and those that plan to use other methods. A recent scientific study we published indicates that OR may also be useful for women that do not have fertility concerns. Look below to learn much more about that.

As noted above, at G5F we offer four options for Ovarian Rejuvenation. One is “Platelet Rich Plasma (PRP),” another is a related procedure called EPF (Enriched Platelet Factors or “EnPLAF”), as well as a hybrid procedure called ULTRA, and an Anti-Ovarian Aging procedure called the ULTIMATE. All of these are designed to further increase the concentration of growth factors you will receive from your activated platelets. Each of these these procedures are designed for specific patients, but in some cases you may have more than one option. We will discuss this important topic with you directly.

 

We offer activated PRP, EPF (EnPLAF) and ULTRA as enhancements of the original clinical trial. Although not all patients respond, our goal is to modify ovarian function to enable a subsequent successful IVF (oocyte retrieval) using the patient’s own eggs. After the Ovarian Rejuvenation procedure is completed, periodic blood testing will be done to monitor one or more of the hormones that reflect ovarian function. These blood tests do not need to be done at Gen 5 Fertility and can be completed at specified intervals at a commercial laboratory near the patient’s home. Some women respond very quickly, while with others, the response is delayed. If a beneficial effect is achieved, it could require approximately three months after Ovarian Rejuvenation for this to be observed. Because another unknown is the expected duration of ovarian ‘rejuvenation’ following this procedure, we encourage patients with a satisfactory response to undergo treatment, usually with IVF (either with us or elsewhere), with a minimal delay once an improvement is seen. For patients seeking this procedure for non-reproductive reasons, early results have also been encouraging.

In February 2018, a procedure known as Enriched Platelet Factors (EPF), like EnPLAF, became available for those who did not respond to standard PRP treatment. As with ovarian PRP, ENPLAF has an established record of safe clinical use in other medical fields; here it is being used for a reproductive application: infertility. With ENPLAF, the ultrasound-guided ovarian injection technique is identical to PRP. But what is inserted into ovarian tissue is highly enriched (and platelet-free) autologous growth factors instead. Studies indicate that the concentration of growth factors may be as much as 10-15 times higher than with PRP alone. Working with associates at Neokine, G5F is currently the only reproductive medicine unit in USA studying this approach to modify ovarian responsiveness as a precursor to IVF. Although this intervention was initially developed as a higher-potency secondary treatment reserved for “PRP failures,” many patients now request and we recommend ENPLAF as the optimal first-line therapy.

PRP, EPF (EnPLAF), and ULTRA treatments all involve carefully inserting cytokines, chemokines, and other growth factors into ovarian tissue. These can be thought of as molecular signals that activate cell growth, angiogenesis (blood vessel growth), and improved blood flow. These changes are thought to improve oocyte number and quality.

At G5F, we have already published findings describing improvements in ovarian function after insertion of PRP — a result that may occur for at least two reasons. One possibility is that the oocytes (eggs) we recovered within several weeks of treatment were really just there all along, but simply awakened from “sleep” by our intervention. Another explanation is that the growth factors from platelets communicated with ovarian stem cells to provide the proper setting to build new eggs.

More information about the scientific basis for these procedures is given at the bottom of this page.

PRP, EPF (EnPLAF), and ULTRA are all completed in less than one day. Because EnPLAF requires platelet incubation, this procedure does take longer than standard PRP. ULTRA required additional time as well since it involves both PRP and EnPLAF. Our Ovarian Rejuvenation patients arrive in the office before 9 am in the morning, have their platelet sample(s) obtained (by blood draw), and then return within 1-4 hours for their procedure. Our nursing team will inform all patients about when to return for the remainder of the treatment.

Studies on ovarian response after PRP are only now beginning to appear in medical journals with the majority of publications coming from our staff and facility. Ours is the only fertility center in the world able to provide all three of these techniques using formal, standardized protocols.

The only way to determine which treatment is best is by matching a patient’s situation with ongoing research here. When we speak with you, we discuss all three options with you and offer PRP, EnPLAF or ULTRA on a case by case basis after reviewing your medical history.

For over a century, the accepted paradigm of the “biological clock” has shaped the understanding of how the ovary changes over time. It is believed by many that a woman is born with all the eggs she will ever have. We also know that a woman’s supply of eggs (her “ovarian reserve”) diminishes with time—this results in a decline in both number and genetic quality of oocytes as she grows older and approaches menopause.

The human ovary is covered by a a layer of tissue that undergoes rupture and repair with each ovulation. This causes considerable wear and tear on the ovary. While stem cells are thought to be crucial for the regeneration, the full role of ovarian stem cells is still unknown. Although recent research has advanced our understanding of ovarian stem cells, treatments based on that understanding are still being developed. The work we perform at Gen 5 Fertility is generating essential data on this important topic.

PRP is perhaps best known for as a remedy for low platelets to improve blood clotting. But PRP also contains factors that orchestrate immune responses and tissue regeneration. Closely associated with inflammation, PRP is important in wound repair and coordinates the complex interplay of several critical related processes (cellular migration, extracellular matrix remodeling, cell proliferation, apoptosis, differentiation, and angiogenesis).

In addition to the now well-established surgical role of PRP in wound healing and tissue repair, scientific data have also suggested that platelets can contribute to overall organ function. Because the main problem in many cases of infertility is ovarian aging and the presumably unstoppable decline in the number of eggs, it seems plausible to consider PRP in a reproductive context as a way to address this challenge. Particularly since the concept of lost ovarian reserve is being challenged by current research here and elsewhere, the possibility of PRP improving the ovarian environment, and even interacting with possible ovarian germline stem cells (GSC) to create new eggs, warrants consideration.

Women who are not fully menopausal and have at least some AMH (anti-mullerian hormone) and antral follicles are more likely to respond. Women with premature ovarian insufficiency (POI) / premature ovarian failure (POF) are more likely to respond if they have not had it for a long period of time.

The good news is that even if only one ovary can be injected with platelet derived growth factors, there does not appear to any reduction in the improvement in ovarian reserve that is seen. Although not yet published, it appears that the much higher concentrations of many growth factors with EnPLAF  yields a generally superior response. We plan to publish data on this question soon.

At G5F, we recently found many things, including age and weight, were not highly predictive of response after growth factor injection into ovarian tissue. However, baseline platelet counts were different. Women with higher platelet levels were more likely to show significant improvements in ovarian reserve. This is why blood tests are recommended before your consult here, so that that information can help guide the decision on which pathway may be best in each situation.

This is a key question, because you may have already completed your family. In 2018, we completed a study based on data from 80 women who had received ovarian PRP. The goal of this research was to find out more about ‘quality of life’ changes they experienced after PRP. In brief, we learned that even when making new eggs is not the goal, important improvements are still possible for many women, including improved sexual function, sleep quality, cervical mucus production, energy level, scalp hair growth, and skin appearance.

Not necessarily. In the registered clinical trial for ovarian PRP in over 180 women here, many patients were already menopausal so they had no ‘cycle day’. Interestingly, some women started having periods again after treatment—a very good sign. For women who are still having regular cycles, we ask that they schedule their procedure during the early first half of their cycle. One of our Ovarian Rejuvenation specialists will give you complete details.

The best medical advice to follow is to get baseline lab tests before you arrive, and more importantly, to avoid aspirin compounds for at least two weeks before your appointment. This applies to both PRP and EPF (EnPLAF), because both treatments depend on platelet health and aspirin has a harmful effect on platelets. The medications you are taking will be assessed and you may be placed on pretreatment medications before you come to Gen 5. you may receive other special instructions. Your Ovarian Rejuvenation coordinator will discuss all of these things with you so that you feel fully comfortable.

PRP. EPF (EnPLAF) and ULTRA are all very well tolerated. Out-of-town patients usually begin the trip back home soon after the procedure is completed and there have been no problems with such travel. On a pain scale of 0 to 10, most PRP and EnPLAF patients rated their pain between 1 and 3. Some patients have no discomfort at all. This low level of discomfort is exactly why anesthesia is rarely necessary. Pain medication is also rarely needed. Our patients have reported improvements in areas such as sleep quality, cervical mucus production, energy level, sexual function, scalp hair growth, skin appearance, menstrual period, and of course, egg production.

Although we are still gathering data to provide a definitive answer to this question, some of our patients have undergone a second ovarian PRP treatment or have had EPF (EnPLAF) after an unsuccessful ovarian PRP and seen a significant response. Other patients choose to plan for multiple Ovarian Rejuvenation procedures and there are packages with reduced costs for these patients. In general, patients who have a poorer prognosis and more likely to require a second procedure, as are those that do not begin a treatment cycle soon after doing the procedure.

It is difficult to generalize about individual health plan coverage, but because Ovarian Rejuvenation is a novel, new procedure, most insurance will not cover it. Please review the terms & conditions of your particular health plan for coverage limits in your situation. If your health insurance plan does not recognize Ovarian Rejuvenation as a covered procedure/service, please contact us for full financial information.

For over a century, the accepted paradigm of the “biological clock” has shaped the understanding of how the ovary changes over time. It is believed by many that a woman is born with all the eggs she will ever have. We also know that a woman’s supply of eggs (her “ovarian reserve”) diminishes with time—this results in a decline in both number and genetic quality of oocytes as she grows older and approaches menopause.

The human ovary is covered by a a layer of tissue that undergoes rupture and repair with each ovulation. This causes considerable wear and tear on the ovary. While stem cells are thought to be crucial for the regeneration, the full role of ovarian stem cells is still unknown. Although recent research has advanced our understanding of ovarian stem cells, treatments based on that understanding are still being developed. The work we perform at Gen 5 Fertility is generating essential data on this important topic.

PRP is perhaps best known for as a remedy for low platelets to improve blood clotting. But PRP also contains factors that orchestrate immune responses and tissue regeneration. Closely associated with inflammation, PRP is important in wound repair and coordinates the complex interplay of several critical related processes (cellular migration, extracellular matrix remodeling, cell proliferation, apoptosis, differentiation, and angiogenesis).

In addition to the now well-established surgical role of PRP in wound healing and tissue repair, scientific data have also suggested that platelets can contribute to overall organ function. Because the main problem in many cases of infertility is ovarian aging and the presumably unstoppable decline in the number of eggs, it seems plausible to consider PRP in a reproductive context as a way to address this challenge. Particularly since the concept of lost ovarian reserve is being challenged by current research here and elsewhere, the possibility of PRP improving the ovarian environment, and even interacting with possible ovarian germline stem cells (GSC) to create new eggs, warrants consideration.

It depends on the reason you’re interested in Ovarian Rejuvenation. When done for reproductive purposes, a hormonal panel and ultrasound, among other things, are performed. We understand that each woman goes through their reproductive life at a different rate. Once we have the information from these tests, we will discuss your options and chance of success with you. If you are doing Ovarian Rejuvenation in an attempt to alleviate menopausal symptoms, the general cut-off age is 59. Please contact us and schedule a consultation to receive personalized recommendations and plans.

Yes. There are many potential causes for menstrual irregularity. We will help you learn what your situation is and let you know your options. We recommend you schedule a consultation with one of our physicians and have an evaluation your situation

As noted in multiple scientific studies from our institution, many patients have seen a substantial increase in their AMH levels after Ovarian Rejuvenation. Increases in AMH are associated with increased numbers of eggs which is associated with increases in pregnancy rates. On all patients, we follow AMH and FSH over time after they receive a procedure. We publish this data on a routine basis.

The procedure is done on by experienced specialist and is done very carefully under ultrasound guidance. Both patients and staff are able to directly observe the procedure. We are pleased that in hundreds of cases, there have been no complications.

Gen 5 Fertility is the world leader in ultrasound-guided Ovarian Rejuvenation. No other center has published as extensively about Ovarian Rejuvenation or reported doing as many cases as we have. We care deeply about Ovarian Rejuvenation and have made multiple changes to how the procedure is done to improve its effectiveness.

While a few other centers offer Generation 1 (PRP) of Ovarian Rejuvenation, they do not publish their data or report how they do this procedure. That is unfortunate because patients don’t have the information they need to make a good decision. We provide detained information about what we do because we know that some patients who need Ovarian Rejuvenation will not be able to travel to see us and we want them to be able to experience the possible benefits that come when the procedure is done correctly.

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