User:Ssam2/sandbox

This is my sandbox. This is where I draft content first.

Diminished Ovarian Reserve/ Premature Ovarian Insufficiency
Conventional IVA or drug free IVA can be used to preserve fertility in patients with Diminished Ovarian Reserve (see Poor Ovarian Reserve) or Premature Ovarian Insufficiency (POI).

Drug free IVA is more beneficial in patients with DOR or POI with recent menses cessation than conventional IVA. This is because it reduces the invasiveness of surgical approaches and circumvents adverse effects of tissue culture on follicles. Traditional IVA is recommended in patients with low ovarian reserve like in patients with POI with prolonged menopause or patients looking for immediate outcomes.

Using drug free IVA, at least a total of 18 healthy live births and three more ongoing pregnancies in POI and DOR patients charted in papers, with additional unpublished deliveries and ongoing pregnancies reported in scientific conferences.

Resistant Ovary Syndrome
Patients with Resistant Ovary Syndrome (ROS) are a subgroup of patients with POI who have multiple antral follicles present in the ovary as shown by ultrasound monitoring. These follicles secrete low levels of oestrogen but are resistant to exogenous follicle stimulating hormone treatment so cannot develop to maturity.

Like patients with POI, ROS patients can respond to incision of the ovarian cortex to cause Hippo signalling disruption. Additionally, laparoscopic ovarian incision (LOI) can be performed in vivo to successfully promote follicle growth without removing tissue outside of the body.

Post-cancer treatment
Oocyte cryopreservation is widely used to protect primordial follicles from gonadotoxic treatment but some patients are not eligible for this, IVA could be a beneficial option for fertility preservation in cancer patients. The IVA approach could maximise the number of secondary oocytes in infertile woman since transplanting ovarian tissue successfully activates the dormant follicle pool.

The IVA method focuses on the short term goal of generating a large number of activated follicles immediately following transplantation of tissue back into the body. This means that the IVA method has a reduced graft lifespan compared to the 4-5 years that can be offered in the cryopreservation method. The graft lifespan relates to the length of time following transplantation back into he body that pregnancies can occur within. This is because IVA promotes loss of dormant follicles to activation so fewer dormant follicles will remain in the graft. This, as a result, reduces graft lifespan. However, this can be beneficial in patients looking for immediate outcomes or to improve her chance of conceiving as fast as possible due to advancing age.

So far, there have been no reported live births but progress is being made in in-vitro research.