PERSPECTIVE METHODS OF PREMATURE OVARIAN FAILURE TREATMENT
V.O. Sribna, T.V. Blashkiv, T.Yu. Voznesenska
- Bogomoletz Institute of Physiology of National Academy of
Sciences of Ukraine,Kyiv, Ukraine
DOI: https://doi.org/10.15407/fz70.04.095
Abstract
Premature ovarian failure (PОF) in women under 40 is a
medical condition in which ovarian follicles are exhausted and
cease to function normally as both reproductive and endocrine
organs. This condition often leads to infertility because it
is associated with hypoestrogenia, which causes menstrual
irregularities and pregnancy failure. Decreased estrogen
secretion also causes many menopausal symptoms, such as
hot flashes, night sweats, and insomnia. In addition, the longterm consequences of POF increase the risk of lifelong skeletal
vulnerability and cardiovascular as well as neurocognitive
disorders. The purpose of the work is to collect, analyze and
summarize data from recent years about promising methods
of treatment of premature ovarian failure, namely about
autologous ovarian tissue transplantation, creation of artificial
ovaries and oocytes, treatment with iron nanoparticles,
intraovarian injections of autolytic platelet-rich plasma. It
should be noted that premature ovarian failure (POF) differs
from menopause in that ovarian failure may not be permanent;
in such patients with POF, pregnancy is spontaneous and
occurs infrequently. Our analysis and summarization of data
from recent years suggests that 1) because autologous ovarian
tissue transplantation requires tissue collection, this method
is generally applicable to a specific patient group, women
who are expected to have ovarian failure after cancer therapy,
and a group of patients who experience gamete depletion as
a result of a prognosis or even a diagnosis of POF. Ovarian
tissue transplantation, which has been known for two decades,
still has significant risks and technical limitations and is not
recognized as a reliable method in clinical practice. 2) the
concept of "artificial ovary" remains at the stage
of experimental development of cellular systems in animals.
Whereas, by creating artificial oocytes from several different
sources (cell types), live birth has already been achieved in
animals. And expectations are aimed at a steady progression
to their clinical use in humans. 3) the use of zero-valent iron
nanoparticles under the conditions of experimental immune
complex failure has a certain corrective effect on the disorder of
ovarian function. There is reason to believe that the effect of the
treatment with zero-valent iron nanoparticles is fundamentally
different from the macroscopic one in the effects on cells
and, apparently, in the mechanisms of action - which requires
further study. 4) treatment with platelet-rich plasma (PRP)
remains an invasive ultrasound-guided procedure with risks
that are not yet fully understood. At this point, PRP should still
be considered an experimental procedure for patients with POF
(premature ovarian failure). It is relevant to continue research
on the influence of PRP components on the ovary, to evaluate
the effect of the PRP concentration, which could play a key
role in the proliferation and differentiation of mesenchymal
cells; and to establish the optimal time intervals between
PRP procedures, the volume treatment, and the maximum
and minimum number of such procedures. In general, the
proposed promising methods (autologous ovarian tissue
transplantation, creation of artificial ovaries and oocytes, use
of nanomaterials (iron nanoparticles), intraovarian injections of
autolytic platelet-rich plasma) are achievements in biomedical
engineering aimed at overcoming infertility, associated with
premature ovarian failure.
Keywords:
premature ovarian failure; autologous transplantation of ovarian tissues; artificial ovaries and oocytes; nanoparticles of zero-valent iron; intraovarian injections of autolytic platelet-rich plasma
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