Influencing Ovarian Aging In Reproductive Medicine: Promise, Evidence, And Unresolved Questions
The natural process of ovarian aging significantly limits female fertility, primarily due to the diminishing supply of eggs and changes within the ovarian environment. In response, several innovative approaches have emerged, attracting considerable interest for their potential to influence this aging process. These include treatments like platelet-rich plasma, therapies utilizing a woman’s own stem cells, and mitochondrial transfer.
These interventions are grounded in scientific hypotheses and have shown some initial promise by affecting surrogate markers, such as levels of anti-Müllerian hormone (a key indicator of ovarian reserve) and the number of small follicles in the ovary. However, despite these early indications, improvements in these markers have not consistently translated into better embryo quality, a higher chance of embryos having the correct number of chromosomes, or ultimately, an increase in live birth rates. Furthermore, comprehensive data on the safety of these procedures remains limited, and there are inherent risks associated with the procedures themselves, including potential for infection.
Given the current state of evidence, experts suggest that the widespread clinical application of these interventions for ovarian aging is premature. Moving forward, it is crucial to establish standardized treatment protocols, conduct robust randomized clinical trials with live birth as the primary outcome, and thoroughly evaluate both the effectiveness and potential risks of these promising, yet unproven, therapies.
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