Early menopausal women could have ovarian function restored

Women experiencing early-stage menopause had their menstrual cycle restored after receiving ovarian injections of platelet-rich plasma (PRP) and gonadotrophins, according to a Taiwanese study, with one woman becoming pregnant after IVF. 

Twelve Han Chinese women were selected to take part in the small pilot study, of whom 11 experienced resumption of their menstrual cycle within an average of 37 days. Mature oocytes were successfully retrieved from six participants using either ovarian stimulation or natural ovulation cycles and fertilised via IVF, with one individual achieving a clinical pregnancy after implantation with a cleavage-stage embryo.

'The retained immature follicles in ovaries of early menopausal women can be enhanced or stimulated to grow to mature follicles employing our new method,' lead author Dr Chao Chin Hsu of Taiwan United Birth-Promoting Experts (TUBE) Fertility Clinic in Tainan, told Healio. 'This administration mode provides another treatment scenario for women of early menopause and those of impending ovarian failure to have better opportunity to conceive using their own eggs.'

Pre-menopausal women often experience higher levels of follicle-stimulating hormone when they are not ovulating, and higher lutenising hormone, than usual. The researchers monitored the levels of these hormones in the participants before and after resumption of menstruation, noting a decline in both cases. 

Dr Jennifer Wu, an obstetrician-gynaecologist at Lenox Hospital, New York, who was not involved in the study warned that the sample size was too small to draw conclusions. 'The percentage success rate for a live birth is not known, and that's what we're really interested in', she told HealthDay.

Additionally, the treatment may only be viable for pre-menopausal women of a certain age. Dr Wu stated that 'Most older patients will have a very hard time getting pregnant, and even if they do get pregnant, they often will have an abnormal pregnancy that doesn't end well'.

However, these findings provide hope for the approximately 12.2 percent of women who experience early menopause, which is defined as menopause before 45 years of age. Due to many women having children later, the impact of this will only increase. 

Future studies should aim to increase and diversify the sample cohort, examining whether similar results can be achieved in women experiencing advanced menopause or by women receiving cancer treatments such as chemotherapy that may cause early menopause. Nonetheless, Dr Stephanie Faubion, medical director of the North American Menopause Society said, the data 'highlights the promise of regenerative medicine in restoring or prolonging fertility.'

The abstract for the study was published in the journal Menopause ahead of publication of the paper.