How Ovarian REjuvenation Works
San Diego's Premier Generation 3 Ovarian Rejuvenation Clinic.
Gen 5 Fertility (G5F) is the first IVF clinic in the United States to focus on therapeutic and research applications for Platelet Rich Plasma (PRP), Enriched Platelet Factors (EPF), including EnPLAF, and the ultimate procedure, ULTRA, all for human Ovarian Rejuvenation.
Now See Exactly How Ovarian Rejuvenation Works.
The video below demonstrates all three Ovarian Rejuvenation procedures: PRP (Platelet Rich Plasma), EPF (Enriched Platelet Factors) including EnPLAF, and ULTRA, the most advanced procedure and one offered nowhere else. Specific details about each are found in this animation.
Gen 5 Fertility Is Leading The Change.
At Gen 5 Fertility, You Are in Good Hands.
Dr. Samuel Wood is one of the leading fertility specialists in the world. He has helped patients from all continents (except Antarctica) 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 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 up to 70% of women. We have published multiple research papers giving details of the procedure and its effects. It is a near-painless procedure for virtually all women and so it requires no anesthesia. It is a safe and affordable technique that gives women who have suffered for so long a chance for success.
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 elective 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. No anesthesia is required.
In addition to other ways these techniques might be helpful, they may stimulate ovarian stem cells so that they develop into eggs. If the number and/or quality of the 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 procedures using established methodologies, including some with precision laboratory support from RegenLab (Lausanne) and Neokine.
Because ovarian PRP 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.
Below we answer many of the questions we have received about this revolutionary technology from patients throughout the world.
We know it can be hard.
If you are really frustrated 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 Generation 3!
Ovarian Rejuvenation FAQs.
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 patient that is concerned that she will do In Vitro Fertilization (IVF) and not have enough eggs or will have eggs that are not high quality should consider Ovarian Rejuvenation (OR). 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 three options for Ovarian Rejuvenation. One is “Platelet Rich Plasma (PRP),” another is a related procedure called “EnPLAF” (EPF) and the third is a hybrid procedure called ULTRA, all of which is designed to further increase the concentration of growth factors you will receive from your activated platelets.
We offer activated PRP, EnPLAF (EPF) 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 a 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 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 ENPLAF (EPF), 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,” some patients have requested ENPLAF as their first-line therapy.
EnPLAF (EPF), PRP, 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.
EnPLAF (EPF), PRP 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.
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