An experimental technique known as platelet-rich plasma (PRP) has recently attracted headlines as a potential fertility treatment to delay or even overcome the menopause and help women get pregnant. This follows results of a small pilot study conducted at the Institute of Life Fertility Clinic in Greece from 2017 to 2019 by Doctor Garavelas Attanasio. However, large scale trials are required to gain more understanding about this technique. It also raises a number of issues about its use in treating the detrimental wider health effects of menopause and whether an upper age limit for mothers should be imposed.
What does PRP treatment entail?
Blood from the patient is extracted and red and white blood cells are removed through centrifugation, leaving concentrated platelets and plasma (known as PRP) which are injected into the woman’s ovaries. Platelets help blood clot and tissue regeneration, and platelet-rich plasma reportedly has the potential to help rejuvenate ovarian function including: increased ovarian hormone production, resumption of menstrual cycles, hormone stabilization and production of eggs which can be fertilised and result in a pregnancy.
Who could benefit from the PRP technique?
The results of the small pilot study at the Institute of Life Athens Fertility Clinic in Greece involved the treatment of approximately 30 women between the ages of 46 and 49, all of whom wanted to have children. Three months after undergoing PRP treatment, 80 percent of the perimenopausal women (who were transitioning into menopause) had pre-menopausal hormone levels and established a regular menstrual cycle and similar outcomes were reported in 13 of the 30 menopausal women. Additionally, one menopausal and three perimenopausal participants reportedly became pregnant following PRP treatment.
Record numbers of women are trying to beat age-related declining fertility levels having delayed pregnancy in their twenties and thirties and attempting to conceive aged 40 and over. PRP could potentially help restore or increase declining fertility in older women and potentially help improve their chances of conceiving their own biological child, particularly as IVF and egg-freezing do not guarantee a successful pregnancy outcome. It also has the potential to help around one percent of women to get pregnant who undergo early menopause as a result of a medical condition or cancer treatment.
Dr. Garavelas at the Institute of Life Fertility Clinic in Athens report that the PRP technique has also helped around 10 per cent of women seeking treatment at their clinic because of embryo attachment issues due to cysts, miscarriage scarring or thin uterine lining.
It is further hoped that PRP treatment could potentially help combat wider detrimental health effects of menopause, wherein changes in hormones make the heart, bones and skin more vulnerable to disease and ageing and subject women to debilitating hot flushes.
Why do we need more medical trials to test PRP treatment?
However, there is still much that is unknown about the efficacy and outcomes of using PRP in fertility treatment because there are no large scale randomised trials. More research is therefore needed to understand where the eggs are coming from and how long any improvements arising from PRP treatment will last for. In addition, as the PRP technique has only been used on a small scale basis, the short and long term risks and any potential side effects are not yet fully understood. As such, despite the recent coverage and interest it remains an experimental treatment.
Specialist legal advice
Specialist fertility and family law advice helps navigate evolving fertility treatment and family building outcomes. It can create a bespoke family building legal and practical action plan to help preserve and maximise individual fertility, understand options and make better informed decisions about conception, family creation, biological identity and legacy and legal outcomes if life does not go to plan. It also helps effectively navigate many complex fertility and family law issues, including:
- Legal issues and options where women face rapidly declining age-related fertility and loss of opportunity for conception (e.g. fertility preservation and maximisation, management of existing personal relationships and implications of using donor gametes).
- Difficulties with storage and use of frozen eggs, sperm and embryos in fertility treatment in the UK (e.g. lack of consent and expiry of storage terms).
- Issues associated with import of frozen gametes and embryos into the UK for use in fertility treatment and surrogacy (e.g. due to anonymous and commercially obtained gametes and embryos which engage UK public policy restrictions).
- Issues associated with the export of frozen gametes and embryos abroad for use in fertility treatment and surrogacy (e.g. lack of consent and storage term difficulties).
- Unexpected death of a loved-one and related issues associated with posthumous storage and use of eggs, sperm and embryos in fertility treatment (e.g. due to an accident, illness including Covid-19).
- Options and legal issues associated with fertility preservation and maximisation (e.g. due to illness, change in personal circumstances, delayed parenthood).
- Uncertainty around availability of egg and sperm donors and surrogates.
- Delays in medical diagnosis and consequent treatment and associated impact on individual fertility.
- Issues associated with assisted conception using gametes or embryos involving a known donor, co-parent or surrogate (e.g. legal parentage, financial responsibility and dispute mitigation).
- Care and upbringing of children following a dispute with an ex-partner, parent, donor or surrogate.