Treatment May Help Women in Early Menopause Remain Fertile

By Steven Reinberg
HealthDay reporter

MONDAY April 5, 2021 (HealthDay News) – Experimental treatment may restore fertility during the onset of menopause, according to a small new study.

Typically, menopause ends a woman’s ability to get pregnant. But the researchers report that giving platelet-rich plasma and hormones called gonadotropins could stimulate ovulation to make pregnancy possible.

“The most surprising finding of this work is the awakening of the sleeping beauty, the restoration of ovulatory function after menopause,” said lead researcher Dr. Chao Chin Hsu, from the Obstetrics and Gynecology Department of the National Taiwan University Hospital in Taipei.

When women enter menopause, their ovaries lose their normal function and there are less than 1000 retained immature ovarian follicles. These immature follicles are usually resistant to gonadotropin or other stimulants, he said.

More and more women are delaying pregnancy until it becomes problematic, and about 12% of women experience early menopause, when ovarian function ceases at age 45 or before.

These women usually need donor eggs to have a chance of becoming pregnant, but techniques that stimulate ovarian function can allow a woman to become pregnant without donor help.

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Researchers believe that these preliminary results could one day give hope to women in the early stages of menopause to get pregnant through in vitro fertilization using their own eggs.

Although platelet rich plasma has been tried in women whose ovaries do not function, only a few pregnancies and childbirths have resulted.

In this pilot study, however, when 12 female ovaries were injected with platelet-rich plasma and gonadotropins, 11 started menstruating again and one became pregnant.

“This treatment is another scenario for women going through menopause and those with impending ovarian failure to have a better chance of conceiving using their own eggs,” Hsu said.

“Our study showed a resumption of follicular growth with elevated levels of the ovarian hormone estradiol in most postmenopausal women who received our treatment, which resulted in rejuvenation for early postmenopausal women,” said Hsu.

In addition, the symptoms of early menopause could be alleviated, he said. “This treatment could also help prevent osteoporosis and cardiovascular disease, even dementia in postmenopausal women, but this requires future studies to prove it,” Hsu noted.

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The results were published online recently in the journal Menopause.

Dr. Jennifer Wu, an obstetrician-gynecologist at Lenox Hill Hospital in New York City, was not part of the research, but reviewed the results. She believes the study included too few women to draw firm conclusions.

“The percentage success rate for a live birth is not known, and that’s what we’re really interested in,” Wu said. “We can’t extrapolate all of this from these tiny numbers, but it’s is very interesting and maybe it would really work for younger patients who have what we call diminished ovarian reserve.

With reduced ovarian reserve, the ovaries lose their normal reproductive potential. The condition can result from illness or injury, but most often occurs as a result of normal aging. About 10% to 30% of women with infertility have it and it is a challenge to deal with.

Wu is skeptical that this treatment used in the study will benefit postmenopausal women.

Most elderly patients will have a hard time getting pregnant, and even if they do get pregnant, they will often have an abnormal pregnancy that does not end well, she said.

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“The problem with the stimulation periods and the eggs is that the eggs may be there, but they may not be normal at that age,” Wu said. “Even if you do get a pregnancy, it’s not a good one. pregnancy. So the question is whether this technology will work better for a patient who is a little younger and who has problems because there are fewer eggs. “

More information

To learn more about early menopause, check out the American Pregnancy Association.

SOURCES: Chao Chin Hsu, MD, PhD, Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; Jennifer Wu, MD, obstetrician-gynecologist, Lenox Hill Hospital, New York City; Menopause, March 31, 2021, online

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