Plasma rich in clotting cells (PRP) is a serum enriched with blood cells that provide coagulation called platelets. These cells, which provide coagulation, contain the necessary growth factors in their structure to repair and restore damaged tissues in the body. In PRP serum, many times more cells than thrombocytes collected in damaged tissues are concentrated.
In the PRP method, this miraculous serum is obtained by taking a small amount of the person’s own blood and then passing through a special series of processes and injected into the person himself. This method is used in many fields of medicine as well as in the field of gynecology. ovary can be applied to the ovaries in women with reduced storage or early menopause diagnosis, and to the uterus in cases where the inner wall of the uterus does not thicken.
History of Plasma Rich from Coagulation Cells
The use of coagulation-rich plasma (PRP) application in medicine first started in the field of hematology, which is a specialty related to blood diseases. Hematology experts first brought up PRP application in 1970. Today, the most common are dentistry, maxillofacial surgery, orthopedic surgeries, plastic surgeries, skin burns or skin wounds and ovaries.
Is There a Place for Plasma Rich in Coagulation Cells in Early Menopause?
The average age of natural menopause is 49 years, and it varies between 45 and 53 years. Early menopause is defined as the onset of the menopausal process before the age of 40. Early menopause is diagnosed when under the age of 40, with infrequent or delayed menstrual periods for at least 4 months and FSH value of blood hormones above 25 mIU / ml. When the complaints of the patients are evaluated, symptoms such as hot flashes, sleep disorders, emotional sensitivity, and vaginal dryness can be encountered. It causes general health problems as well as serious problems in fertility.
What are the causes of early menopause?
The reason is unknown in 6 out of 10 patients with early menopause. Among the detectable reasons, the most common cause is familial causes; If there is a history of early menopause in the mother, aunt or sisters of the person, the risk of early menopause increases 4-9 times. Another reason is that cells called antibodies against one’s own cells develop for an unknown reason and damage their own ovaries and the menopause process accelerates as a result of a decrease in ovarian reserve. Finally, there are genetic reasons. In addition to this, smoking and excessive coffee consumption also cause rapid consumption of ovarian stores.
Treatment Options in Early Menopause
After detailed information, depending on whether there is a fertility desire or not, either hormone supplements or in vitro fertilization can be applied. The possibility of obtaining an egg is very low with the egg enlargement drugs used in IVF treatment.
Was There a Place for Plasma Rich in Coagulation Cells in Early Menopause r?
PRP serum containing more than 800 protein molecules, hormones and growth factors can be used in many areas of medicine, based on the discovery that it stimulates cell proliferation, growth and differentiation and increases blood supply in tissues, cell migration, proliferation of tissues, as well as early menopause and ovarian diseases. It has been used in patients with limited reserve. In the light of scientific evidence, after PRP treatment to the ovaries, the number of eggs increased and improvement in blood hormones was reported. Subsequently, pregnancies were reported either spontaneously or after IVF treatment.
Is There a Place for Plasma Rich in Coagulation Cells in a Decreased Egg Reserve?
Today, especially due to the increase in living conditions and the increase in the place of women in working life, delaying the childbearing age to advanced ages causes more patients with reduced ovarian reserve. Decreased egg reserve can be expressed as a woman of reproductive age having fewer egg sacs compared to other women in her age group. In 2011, the European Society of Reproductive Medicine defined a low ovarian response. According to this:
1- Expectant mothers over a certain age (40 years of age) or having undergone medication, radiation therapy, ovarian surgery due to cancer constitute a risk factor for poor ovarian reserve.
2- Less than 3 eggs obtained after previous IVF treatment
3- Presence of a decreased ovarian reserve test (the number of egg sacs examined in ultrasonography is below 5-7 and / or the egg reserve test in blood has low values (Anti Mueller Hormone <1.2 ng / mL)).
Why Is the Ovarian Reserve Decreasing?
Every woman is born with a certain number of eggs, and over the years the egg heritage is gradually depleted, and then the menopausal period begins. However, the rate of decrease has different acceleration in each patient. This situation can be explained in two different ways:
1- Lack of follicle inheritance left in the uterus
2- It can be explained by the rapid loss of ovaries for various reasons.
Patients who may be at risk of reduced egg reserve;
- Patients over 35 years old
- History of early menopause in family
- Previous ovarian or cyst surgeries,
- Chocolate cysts
- History of cancer-induced drugs or radiation therapy
- Having harmful habits such as smoking and alcohol
- Woman being overweight
- Presence of certain genetic diseases such as fragile X syndrome, mosaic turner syndrome.
Who Can Apply PRP IVF?
Although plasma rich in coagulation cells (PRP) is a very new application, it is a promising application for women with reduced ovarian reserve and early menopause diagnosis. Although scientific research on this subject is still limited, positive results have been reported after PRP application.
When Can Plasma Treatment Rich From Coagulation Cells Be Applied?
PRP can be applied at any time after the end of menstruation in couples who are planned to be treated with Plasma Rich in Coagulation Cells (PRP).
How is Plasma Rich in Coagulation Cells applied?
Approximately 20 ml of blood is taken from the person whose Coagulation Cells Rich Plasma (PRP) treatment is planned, and after centrifugation (separation of liquid and solid substances) in a special tube, the separated serum is applied to the ovaries under general anesthesia on the same day. The process time can vary between about 15-30 minutes. Our patient is discharged on the same day after being followed up in the recovery room for 30-60 minutes after the procedure and making sure that everything is in order. A period of 2-6 months is needed for the application to take effect. Changes in the ovaries are checked periodically by ultrasonography and blood tests. PRP application can be repeated every 4-6 months.
What Are the Possible Risks of Plasma-Rich Coagulation Cells Process?
Since plasma rich in coagulation cells (PRP) treatment, injection into the ovaries is a new method, information about the risks is very limited. Since serum rich in blood cells called platelets is separated and given back to the same person, it is defined as autotransfusion and the risk of allergic reaction is thought to be minimal. Risks associated with the PRP procedure include bleeding from the injection site or vaginal veins, infection, and neighboring organ injury.
What should be considered before and after application of Plasma Rich from Coagulation Cells?
Considerations Before Treatment
- Having at least 8 hours of fasting before treatment
- Not using alcoholic beverages before treatment
- It is necessary to stop ginkgo biloba (temple tree), blood thinners, green tea, aspirin, and non-steroidal anti-inflammatory (rheumatic) drugs at least 3 days in advance.
Considerations After Treatment
- PRP After the procedure, our patients can rest for 30-60 minutes and leave our hospital.
- We recommend staying at home for 1 day after the PRP procedure.
- One day after the PRP procedure, you can take a bath with warm water and standing shower.
- The prohibition of sexual intercourse continues for 7 days.
- Activities such as sports and heavy work should be avoided, but daily tasks that will not tire our patients can be done.
- Daily feeding can be continued after the PRP procedure. In order to avoid constipation, it will be beneficial to avoid fatty and spicy foods and to prefer easy-to-digest foods such as soup and fibrous vegetables and fruits.
What will be the follow-up after Plasma Rich Coagulation Cells Application?
Follow-up Method after PRP:
- PRP We recommend menstrual regulator to women who do not have any period after the procedure.
- The first control is usually in the second menstrual period, but in some cases, control can be recommended during the first period.
- Control time is usually between the second and fourth days of menstruation.
- The primary control method is to evaluate the ovaries ultrasonographically and to monitor whether the egg sacs are monitored in women who have not had an egg sac (follicle) before.
- In some cases, blood hormone levels can be evaluated simultaneously.
- If a significant response is not observed in the controls, re-examination may be recommended in the next menstrual periods.
How Many Times Can Plasma-Rich Coagulation Cells Process Be Applied?
Plasma Rich from Coagulation Cells (PRP) treatment can be repeated at 6-month intervals, provided that there is no change in the egg sac (follicle), although 6 menstrual periods have passed in the subsequent controls.
Is There Not Any Benefit From Plasma Treatment Rich From Coagulation Cells? If we don’t benefit, how are we judged not to benefit?
In our women who have not had any follicles before in their controls after Coagulation Cells Rich Plasma (PRP) application, although 6 menstrual periods have passed, you may be considered by your physicians as not benefiting from the PRP procedure. The fact that there is no significant increase in the number of egg sacs (follicles) in the follow-up after PRP in patients with a tendency to decrease egg storage is not directly defined as not being beneficial, because we think that PRP may have an improvement effect on egg quality as well as an increase in the number of follicles.