Comparative analysis of the use of autologous exosomes and platelet-derived growth factors in women with premature ovarian insufficiency and infertility: A prospective, randomized, observational, analytical study

Stromal fibrosis and ovarian aging depend not only on the age of the patients but also on environmental factors, lifestyle and physiological events such as ovulation itself, which leaves repeated scarring in the ovarian stroma, limiting normal tissue vascularization and the provision of biological s...

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Main Authors: Carmen Navarro, Pedro Torrecillas Cabrera, Alejandro Teppa Garrán
Format: Article
Language:English
Published: Elsevier 2025-12-01
Series:Regenerative Therapy
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352320425001403
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author Carmen Navarro
Pedro Torrecillas Cabrera
Alejandro Teppa Garrán
author_facet Carmen Navarro
Pedro Torrecillas Cabrera
Alejandro Teppa Garrán
author_sort Carmen Navarro
collection DOAJ
description Stromal fibrosis and ovarian aging depend not only on the age of the patients but also on environmental factors, lifestyle and physiological events such as ovulation itself, which leaves repeated scarring in the ovarian stroma, limiting normal tissue vascularization and the provision of biological signals necessary to maintain folliculogenesis and hormone synthesis. In a fibrosed ovarian stroma, there is a decrease in hyaluronic acid concentrations, loss of synthesis and migration proteins, a decrease in microRNAs, in addition to enzymatic alterations that affect mitochondrial kinases, increasing oxygen free radicals, which accelerate cell death. Objectives: This study seeks to analyze the effectiveness of autologous exosomes in reversing aging and bioregenerating the ovary of patients with ovarian failure and infertility by improving interstitial fibrosis and providing the necessary elements to activate neofolliculogenesis. Methodology: Prospective, randomized, comparative study in 30 women between 38 and 46 years old, with diminished ovarian reserve and who rejected the egg donation procedure. Three study groups composed of 10 patients each: the first with autologous exosomes, the second with PRP and the third with saline solution. Results: After completing the study, it was found that women in the Autologous Exosome group showed better ovarian reserve parameters such as FSH, LH, Estradiol, Anti-Müllerian Hormone and antral follicle count, edema of more oocytes collected in Metaphase II, higher fertilization rate, frozen embryos and positive pregnancies. Conclusion: Ovarian Biostimulation with Autologous Exosomes could be considered a safe and promising therapy to improve markers of low ovarian reserve. Trial registration: Clinical Trials.gov. Registration Number: NCT06773572. URL: Study Details | Use of Autologous Exosomes vs Platelet Growth Factors to Regenerate the Ovary in Women With Infertility (Exosomas2024-1) | ClinicalTrials.gov.
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spelling doaj-art-b4259b2af25643ca85ab1da98b3054af2025-08-20T03:28:28ZengElsevierRegenerative Therapy2352-32042025-12-013030932010.1016/j.reth.2025.06.007Comparative analysis of the use of autologous exosomes and platelet-derived growth factors in women with premature ovarian insufficiency and infertility: A prospective, randomized, observational, analytical studyCarmen Navarro0Pedro Torrecillas Cabrera1Alejandro Teppa Garrán2Women Fertility Center and Women Care Center, Venezuela; Corresponding author.Medical Center of Urology, Andrology and Sexual Medicine of Malaga, SpainMetropolitan Polyclinic, Caracas, VenezuelaStromal fibrosis and ovarian aging depend not only on the age of the patients but also on environmental factors, lifestyle and physiological events such as ovulation itself, which leaves repeated scarring in the ovarian stroma, limiting normal tissue vascularization and the provision of biological signals necessary to maintain folliculogenesis and hormone synthesis. In a fibrosed ovarian stroma, there is a decrease in hyaluronic acid concentrations, loss of synthesis and migration proteins, a decrease in microRNAs, in addition to enzymatic alterations that affect mitochondrial kinases, increasing oxygen free radicals, which accelerate cell death. Objectives: This study seeks to analyze the effectiveness of autologous exosomes in reversing aging and bioregenerating the ovary of patients with ovarian failure and infertility by improving interstitial fibrosis and providing the necessary elements to activate neofolliculogenesis. Methodology: Prospective, randomized, comparative study in 30 women between 38 and 46 years old, with diminished ovarian reserve and who rejected the egg donation procedure. Three study groups composed of 10 patients each: the first with autologous exosomes, the second with PRP and the third with saline solution. Results: After completing the study, it was found that women in the Autologous Exosome group showed better ovarian reserve parameters such as FSH, LH, Estradiol, Anti-Müllerian Hormone and antral follicle count, edema of more oocytes collected in Metaphase II, higher fertilization rate, frozen embryos and positive pregnancies. Conclusion: Ovarian Biostimulation with Autologous Exosomes could be considered a safe and promising therapy to improve markers of low ovarian reserve. Trial registration: Clinical Trials.gov. Registration Number: NCT06773572. URL: Study Details | Use of Autologous Exosomes vs Platelet Growth Factors to Regenerate the Ovary in Women With Infertility (Exosomas2024-1) | ClinicalTrials.gov.http://www.sciencedirect.com/science/article/pii/S2352320425001403Autologous exosomesPlatelet-derived growth factorOvarian regenerationOvarian insufficiencyInfertility
spellingShingle Carmen Navarro
Pedro Torrecillas Cabrera
Alejandro Teppa Garrán
Comparative analysis of the use of autologous exosomes and platelet-derived growth factors in women with premature ovarian insufficiency and infertility: A prospective, randomized, observational, analytical study
Regenerative Therapy
Autologous exosomes
Platelet-derived growth factor
Ovarian regeneration
Ovarian insufficiency
Infertility
title Comparative analysis of the use of autologous exosomes and platelet-derived growth factors in women with premature ovarian insufficiency and infertility: A prospective, randomized, observational, analytical study
title_full Comparative analysis of the use of autologous exosomes and platelet-derived growth factors in women with premature ovarian insufficiency and infertility: A prospective, randomized, observational, analytical study
title_fullStr Comparative analysis of the use of autologous exosomes and platelet-derived growth factors in women with premature ovarian insufficiency and infertility: A prospective, randomized, observational, analytical study
title_full_unstemmed Comparative analysis of the use of autologous exosomes and platelet-derived growth factors in women with premature ovarian insufficiency and infertility: A prospective, randomized, observational, analytical study
title_short Comparative analysis of the use of autologous exosomes and platelet-derived growth factors in women with premature ovarian insufficiency and infertility: A prospective, randomized, observational, analytical study
title_sort comparative analysis of the use of autologous exosomes and platelet derived growth factors in women with premature ovarian insufficiency and infertility a prospective randomized observational analytical study
topic Autologous exosomes
Platelet-derived growth factor
Ovarian regeneration
Ovarian insufficiency
Infertility
url http://www.sciencedirect.com/science/article/pii/S2352320425001403
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