By Steven Reinberg
HealthDay reporter
MONDAY, April 5, 2021 (HealthDay News) – An experimental treatment may restore fertility in early menopause, a small new study says.
Usually, menopause ends a woman’s ability to get pregnant. However, researchers report that administration of platelet-rich plasma and hormones called gonadotropins could stimulate ovulation to enable pregnancy.
“The most surprising result of this work is the Sleeping Beauty awakening and restoration of ovulatory function after menopause,” said lead researcher Dr. Chao Chin Hsu from the Obstetrics and Gynecology Department at the National Taiwan University Hospital in Taipei.
When women enter menopause, their ovaries lose their normal function and there are fewer than 1,000 immature ovarian follicles. These immature follicles are typically resistant to gonadotropin or other stimulants, he said.
More and more women are delaying pregnancy until it becomes problematic, and around 12% of women experience early menopause if ovarian function stops at or before the age of 45.
These women usually need donor eggs to get pregnant, but techniques that stimulate ovarian function can allow a woman to conceive without donor help.
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The researchers believe that these preliminary results may one day give hope to early menopausal women that they could become pregnant with their own eggs through in vitro fertilization.
Although platelet-rich plasma has been tried in women whose ovaries are not functioning, pregnancies and childbirths have been few.
However, in this pilot study, when 12 women’s ovaries were injected with platelet-rich plasma and gonadotropins, 11 began menstruating again and one became pregnant.
“This treatment is another scenario for women in early menopause and for women with impending ovarian failure who have a better opportunity to use their own eggs,” Hsu said.
“Our study showed that most menopausal women who received our treatment had regained follicle growth with increased levels of the ovarian hormone estradiol, which led to rejuvenation in early menopausal women,” Hsu said.
Symptoms of early menopause could also be relieved, he said. “This treatment could also help prevent osteoporosis and cardiovascular disease or even dementia in menopausal women, but that will require future studies to prove this,” Hsu noted.
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The results were recently published online in the journal Menopause.
Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City, was not part of the research but did review the results. She believes the study included too few women to draw definitive conclusions.
“The percent success rate for a live birth is unknown, and we really care,” said Wu. “We can’t extrapolate any of this from these tiny numbers, but it’s very interesting and maybe it would really work for younger patients who have what is called decreased ovarian reserve.”
In a reduced ovarian reserve, the ovaries lose their normal reproductive potential. The condition can result from illness or injury, but most commonly occurs as a result of normal aging. Approximately 10% to 30% of women with infertility suffer from this condition, and treating it is challenging.
Wu is skeptical that the treatment used in the study will benefit menopausal women.
Most elderly patients will have a very difficult time getting pregnant, and even when they do become pregnant, they often have abnormal pregnancies that don’t end well, she said.
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“The problem with stimulating periods and eggs is that the eggs may be there but may not be normal at that age,” said Wu. “Even if you get pregnant, it’s not a good pregnancy. So the question is, will this technology actually work better for a patient who is a little younger and has problems with fewer eggs?”
More information
For more information on early menopause, visit the American Pregnancy Association.
SOURCES: Dr. med. Chao Chin Hsu, Obstetrics and Gynecology Department, National Taiwan University Hospital, Taipei, Taiwan; Jennifer Wu, MD, obstetrician and gynecologist, Lenox Hill Hospital, New York City; Menopause, March 31, 2021, online
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