Mechanical ovarian stimulation in patients with early menopause
Ovarian failure and early menopause affect 1% of women in fertile age. The disappearance of the hormonal function and the decrease of the ovarian reserve limits the possibilities of pregnancy with own eggs. For this reason, in order to become mothers, the majority of these patients turn to in vitro fertilization with donor eggs to become mothers. For these women, there is now an experimental method based on mechanical stimulation, which allows them to become mothers with their own eggs.
It is important to know the ovarian reserve of a woman, i.e., the number of eggs per cycle that she can develop at a given moment of her life. For this, it is necessary to perform two tests. First, a transvaginal ultrasound in the first days of the cycle with an antral follicle count (AFC). Subsequently, at any time of the ovarian cycle an analytical determination of the Anti-Müllerian hormone (AMH) is carried out. An abnormal value of the Anti-Müllerian hormone may be an indicator of premature ovarian failure. Other analytical parameters to be taken into account are basal hormones (FSH, LH and estradiol).
Mechanic stimulation of the most superficial part of the ovary is an experimental method used to treat early menopause. So far, it has been accomplished, that a small proportion of young patients have been able to partially reactivate its function. Thus, it is possible to resume the hormone production of the ovary and have the possibility to recover own oocytes in light of a premature ovarian failure. Among the different techniques of ovarian rejuvenation that have been used in clinical trials in the recent years, the effect of stimulating the surface of the ovary at a mechanical level seems to offer the same results without the need of injecting particles or substances within it.
This technique can be only carried out in patients younger than 40 years who do not have a history of previous treatments that could reduce the ovarian reserve. Patients must not have been subject to therapies or interventions that could have affected their fertility. Some of them are chemotherapy, pelvic radiotherapy or ovarian surgery, benign injuries (endometriosis, dermatologic cysts) or tumour- related injuries.
Retrieve the highest possible amount of eggs
The technique of mechanical stimulation requires the completion of a minor laparoscopic ambulatory surgery. At the surgery, the most superficial layer of the ovaries is stimulated in order to try to make it resume its function. Immediately, a hormone stimulation is conducted. The goal of this procedure is to try to retrieve the highest possible amount of eggs. It is always recommended to associate the in vitro fertilization treatment with a preimplantation genetic diagnosis (PGD).
Thanks to this technique, Institut Marquès, medical centre specialized in especially difficult cases in the areas of Gynaecology and assisted reproduction, offers patients with early menopause the possibility of trying to become mothers with their own genetic material. These techniques have only been successful in a small amount of patients. To undergo this treatment you need to consider a trip to our clinic in Barcelona.