Specialised procedures for the female partner
Specialised procedures for the female partner could be related to preparing the ovaries, the oocytes, or the uterine lining.
Whether any of these will be suitable for you depends on the individual characteristics of your case. Your treating consultant is familiar with and will consider all relevant detail in making the decision.
PRP (Platelet Rich Plasma), also known as plasma therapy, is a medical method that has been successfully applied in various conditions, including gynaecology.
This method uses the patient’s own blood. A blood sample is collected and processed at the lab under sterile conditions to isolate plasma enriched with platelets that are subsequently activated. Platelets are tiny blood cells that regularly participate in blood clotting, tissue regeneration, and healing processes. PRP is typically applied locally by injection directly into the target tissues. Platelets release various proteins: enzymes, cytokines and growth factors, which enhance many processes, like the formation of new blood vessels, improved innervation, and recruiting stem cells to the application site. The aim is to stimulate tissue regeneration processes and renew normal tissue functions.
The advantage of the therapy using the patient’s own cells lies in reducing the risk of allergic reactions. At the same time, these cells contribute to the body’s natural healing mechanisms, which are activated to regenerate the target tissues.
PRP’s safety has been confirmed in more than 20 years of clinical applications in many fields of medicine.
In assisted reproduction, PRP is used in several directions, including at our hospital:
- Improvement of the functional layer of the uterus, where the embryo implants. PRP is infused into the uterine cavity to stimulate the thickening of the endometrium and enhance its functional properties. It is applied in patients with endometrial malfunction and repeated IVF failures.
- Improvement of ovarian function. Applied in patients with premature ovarian insufficiency and diminished ovarian reserve. PRP is injected into the ovary in a procedure similar to oocyte retrieval.
- Treatment of vaginal pathologies – in cases of vaginal atrophy.
- Enhancing spermatogenesis – in patients with no spermatozoa in the ejaculate or very low sperm counts, as well as of very poor sperm morphology. PRP is applied by injection in the testes.
- Enhancing sexual function in men – in erectile dysfunction (ED) cases. PRP is applied in specific cases where certain causes of ED have been ruled out. It is injected into the penis.
PBMC (peripheral blood mononuclear cells) is a preparation of mononuclear cells from peripheral blood. They consist mainly of lymphocytes, monocytes, macrophages and dendrite cells. This mix of immune cells can be isolated from the patient’s blood and be used in local treatment applications.
A blood sample is collected from the patient and processed to extract the PBMCs. After purification and cultivation under specific conditions in the lab, the cells are transferred to the woman’s uterus.
PBMC is generally applied in women with deviations in the immune profile, confirmed by endometrial biopsy, and in patients with multiple failed IVF cycles.
PBMCs modulate the maternal immune response by the cytokines, chemokines and growth factors they release. In this way, they significantly enhance the uterine environment and make it favourable to embryo implantation.
A large body of research studies, including such carried out at our hospital, confirm a significant increase of successful pregnancies following PBMC application in the specific patient populations studied (with recurrent IVF failures and immune profile deviations).
From blood collection to PBMC application, the whole procedure takes two days. Patient blood samples are collected on two separate days. PBMCs are ready to administer two hours after the second blood collection.
Cryopreservation is used to maintain the viability of cells over long periods. It is achieved by freezing and liquid nitrogen storage at ultralow temperatures – 196°C. At Nadezhda hospital, we employ vitrification, the most modern and effective cryopreservation technique. Vitrification is a freezing method with ultra-fast cooling rates. Upon contact with liquid nitrogen, the intracellular water transitions into a glass-like (vitrified) state without forming ice crystals. Ice crystal formation is the leading cause for loss of cell viability if freezing is attempted with no special cryoprotectants or techniques. In vitrification, commercially developed media are used to replace a part of intracellular water with cryoprotectants. In this way, cells have additional protection from cryogenic damage. After incubation in a cryoprotectant solution, the oocytes or embryos are placed onto special devices (the so-called straws) and directly submerged into liquid nitrogen. The technique is highly reliable, yielding more than 95% preserved viability and development potential, both in embryos and oocytes.
Through the ‘Keep Hope Alive’ project, Nadezhda Hospital is actively engaged in fertility preservation for cancer patients and patients with autoimmune and rheumatoid diseases.