Article: Drug-free Activation for Primary Ovarian Insufficiency

Primary Ovarian Insufficiency (POI) or Diminished Ovarian Reserve (DOR) are the two conditions that affects women leading to infertility due to the lack of follicular growth and ovulation. Egg / Oocyte donation remains an option for these patients. However, with the development in Reproductive medicine various novel technologies like Ovarian Cryopreservation, Fragmentation, activation with drug treatment or even drug free autotransplantation enables the possibility of activating the pool of primordial follicles that can lead to successful pregnancy outcomes. Here, we report a case of women with POI, in which drug free activation of follicles was performed, followed by autotransplantation, which resulted in successful pregnancy. This is first case report from India that shows the procedure works and can be tried for women with POI.

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References

1.

Griesinger G, Fauser B . Drug-free in-vitro activation of ovarian cortex; can it really activate the 'ovarian gold reserve'?. Reprod Biomed Online. 2020; 40(2):187-189. DOI: 10.1016/j.rbmo.2020.01.012. View

2.

Kawamura K, Cheng Y, Suzuki N, Deguchi M, Sato Y, Takae S . Hippo signaling disruption and Akt stimulation of ovarian follicles for infertility treatment. Proc Natl Acad Sci U S A. 2013; 110(43):17474-9. PMC: 3808580. DOI: 10.1073/pnas.1312830110. View

3.

Li J, Kawamura K, Cheng Y, Liu S, Klein C, Liu S . Activation of dormant ovarian follicles to generate mature eggs. Proc Natl Acad Sci U S A. 2010; 107(22):10280-4. PMC: 2890455. DOI: 10.1073/pnas.1001198107. View

4.

Fabregues F, Ferreri J, Calafell J, Moreno V, Borras A, Manau D . Pregnancy after drug-free in vitro activation of follicles and fresh tissue autotransplantation in primary ovarian insufficiency patient: a case report and literature review. J Ovarian Res. 2018; 11(1):76. PMC: 6119245. DOI: 10.1186/s13048-018-0447-3. View

5.

Reddy P, Liu L, Adhikari D, Jagarlamudi K, Rajareddy S, Shen Y . Oocyte-specific deletion of Pten causes premature activation of the primordial follicle pool. Science. 2008; 319(5863):611-3. DOI: 10.1126/science.1152257. View