Biological therapies for premature ovarian insufficiency: what is the evidence?

Melpomeni Moustaki; Adamantia Kontogeorgi; Gkalia Tsangkalova; Haralampos Tzoupis; Antonis Makrigiannakis; Andromachi Vryonidou; Sophia N Kalantaridou

doi:10.3389/frph.2023.1194575

Biological therapies for premature ovarian insufficiency: what is the evidence?

Front Reprod Health. 2023 Sep 7:5:1194575. doi: 10.3389/frph.2023.1194575. eCollection 2023.

Authors

Melpomeni Moustaki¹, Adamantia Kontogeorgi², Gkalia Tsangkalova², Haralampos Tzoupis², Antonis Makrigiannakis³, Andromachi Vryonidou¹, Sophia N Kalantaridou^{2

4}

Affiliations

¹ Department of Endocrinology and Diabetes Center, Hellenic Red Cross Hospital, Athens, Greece.
² Serum IVF Fertility Center, Athens, Greece.
³ Department of Obstetrics and Gynecology, University of Crete Medical School, Heraklion, Greece.
⁴ 3rd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Medical School, Athens, Greece.

Abstract

Premature Ovarian Insufficiency (POI) is a multi-factorial disorder that affects women of reproductive age. The condition is characterized by the loss of ovarian function before the age of 40 years and several factors have been identified to be implicated in its pathogenesis. Remarkably though, at least 50% of women have remaining follicles in their ovaries after the development of ovarian insufficiency. Population data show that approximately up to 3.7% of women worldwide suffer from POI and subsequent infertility. Currently, the treatment of POI-related infertility involves oocyte donation. However, many women with POI desire to conceive with their own ova. Therefore, experimental biological therapies, such as Platelet-Rich Plasma (PRP), Exosomes (exos) therapy, In vitro Activation (IVA), Stem Cell therapy, MicroRNAs and Mitochondrial Targeting Therapies are experimental treatment strategies that focus on activating oogenesis and folliculogenesis, by upregulating natural biochemical pathways (neo-folliculogenesis) and improving ovarian microenvironment. This mini-review aims at identifying the main advantages of these approaches and exploring whether they can underpin existing assisted reproductive technologies.

Keywords: HRT; PRP; Premature Ovarian Insufficiency; biological therapies; exosomes; in vitro activation; microRNAs; stem cell therapy.

Publication types

Review