E. Scott Sills*, Samuel H. Wood

Sills et al. J Clin Transl Res 2022; 8(1):8

Published online: January 25, 2022

Background: Interest in decelerating or reversing reproductive aging is unlikely to diminish in the era of molecular genetics. For the adult human ovary, meeting the challenge of menopause without synthetic hormone replacement has now moved beyond proof-of-concept, as shown from treatments validated with standard metabolic markers and ovarian reserve estimates. However, without proper recruitment and differentiation of oocytes, such outcomes would be impossible. The full inventory of factors required for such folliculogenesis is not yet final, but growth differentiation factor-9 (GDF-9), transforming growth factor-beta1 (TGF-β1), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1) are consistently identified as relevant. Platelet-derived growth factor (PDGF) and, more recently, bone morphogenic proteins (BMPs) are also central to cell migration, vascular support, and general ovarian function. Interestingly, when cells secreting these moieties are surgically grafted near undifferentiated oocyte stem precursors, the latency phase transitions to delineate follicle development and restoration of reproductive capacity. Direct intraovarian injection of condensed platelet-derived cytokines (a platelet-rich plasma/PRP product) likewise enables return of menses, ovulation, and term livebirth.
Aim: This report extends our previous work on the proangiogenic effects of intraovarian PRP by connecting clinical responses to specific cytokine-dependent gene activation pathways likely needed to induce oocyte differentiation.
Relevance for patients: Ovarian rejuvenation is a promising new application for platelet-rich plasma and/or condensed plasma cytokines of platelet origin, which are injected into older ovarian tissue.

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DOI: http://dx.doi.org/10.18053/jctres.08.202201.008

Author affiliation

1. Reproductive Research Section, Center for Advanced Genetics; San Clemente, California USA
2. Department of Obstetrics & Gynecology, Palomar Medical Center; Escondido, California USA
3. Gen 5 Fertility Center; San Diego, California USA

*Corresponding author
E. Scott Sills
CAG/FertiGen, P.O. Box 73910, San Clemente CA 92673 USA
 Tel: +1 949-899-5686
Email: ess@prp.md

Handling editor:
Michal Heger
Department of Pharmaceutics, Utrecht University, the Netherlands
Department of Pharmaceutics, Jiaxing University Medical College, Zhejiang, China

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