Alexander’s Library

The search for the elixir of youth — what the record says, and how strongly. Double-click any word for an instant dictionary or scientific synopsis.

Library / Natural & Life Sciences / Medicine, Health & Longevity / Reproductive Medicine & Human Fertility / Advanced Maternal Age & Pregnancy After 40

Translational & Geroprotective Reproductive Biology

Synthesise the peer-reviewed record on frontier studies on 40+ fertility and new clinical trials: systematic reviews, randomised clinical trials, large cohort studies, quantitative effect sizes, safety signals, and active trials.

68 sources ↓Last researched 2026-10-18
Hierarchy:
Natural & Life SciencesMedicine, Health & LongevityReproductive Medicine & Human FertilityAdvanced Maternal Age & Pregnancy After 40Translational & Geroprotective Reproductive BiologyAutologous Ovarian Rejuvenation TherapiesIn Vitro Gametogenesis and Oocyte BioengineeringMitochondrial and Cytoplasmic Transfer TechnologiesPreimplantation Genetic Testing and Diagnostic BiomarkersSenolytic and Anti-Aging Ovarian Therapeutics
+ Associated nodes:
Antioxidants (intersects) Mitochondrial Medicine (intersects)
State of the Field Monograph · AI Research Synthesis6 min read · 68 sources · 26 graded findingsPeak certainty: T1

State of the Field: Translational & Geroprotective Reproductive Biology

Synthesise the peer-reviewed record on frontier studies on 40+ fertility and new clinical trials: systematic reviews, randomised clinical trials, large cohort studies, quantitative effect sizes, safety signals, and active trials. Grounded synthesis across 68 primary sources and 26 graded findings within Reproductive Medicine & Human Fertility → Advanced Maternal Age & Pregnancy After 40.

Synopsis · Executive Overview

Frontier interventions for female fertility in women aged 40 and older span regenerative biology, cellular bioenergetics, and embryo selection, but robust clinical efficacy remains scarce. In autologous IVF, achieving optimal cumulative live birth rates above age 35 requires approximately 9 to 12 metaphase II oocytes, yet blastocyst euploidy drops to 37.7%–38.5% at ages 39–40+ alongside a steep age-dependent risk inflection at 42. Autologous intraovarian platelet-rich plasma (PRP), despite widespread commercial adoption, provides only very low-certainty evidence across 12 randomized controlled trials (n=1,069) with no proven benefit on live birth rates. Mitochondrial replacement therapies and autologous stem cell mitochondrial transfers have produced anecdotal live births in small observational cohorts, but animal models and independent reviews highlight persistent epigenetic concerns, blastocyst arrest, and a lack of controlled efficacy. Noninvasive preimplantation genetic testing (niPGT-A) achieves 70% to 85% sensitivity and 88% to 92% specificity, but faces high technical hurdle rates including 10% to 50% DNA amplification failure and day-6 culture risks. Finally, in vitro gametogenesis (IVG) remains restricted to preclinical rodent models, with primate and human translational progress stalled by meiotic entry efficiencies below 1%.

Section I · Primary Literature & Evidence Synthesis

What the Peer-Reviewed Record Establishes

The primary research record in Translational & Geroprotective Reproductive Biology is stratified by study design so that meta-analyses and replicated randomised controlled trials (T1–T2) carry greater epistemic weight than observational cohorts (T3–T4) or preclinical laboratory work (T5). Leading graded findings establish the core empirical baseline: [T1] In vitro gametogenesis has enabled meiotic entry from primate pluripotent stem cells and fetal germ cells across 23 studies, but functional primate oogenesis to full maturity remains unachieved unlike in murine models. [19][12] [T1] Next-generation sequencing-based PGT-A that incorporates segmental imbalance and mosaicism prediction displays significantly higher diagnostic discordance upon blastocyst reanalysis across 1,271 embryos and 2,260 pairwise comparisons from 26 studies. [50]

Further clinical and mechanistic stratification across the literature demonstrates: [T1] In women undergoing assisted reproduction, autologous platelet-rich plasma (PRP) evaluated across 12 RCTs (n=1,069) provides very low-certainty evidence for outcomes such as live birth and miscarriage, indicating that clinical implementation for ovarian rejuvenation remains premature. [25][40] [T1] Cellular senescence in ovarian cell types contributes to female reproductive aging, and senotherapeutic interventions are under active investigation to eliminate senescent cells and extend reproductive longevity. [7][23]

Section II · Mechanisms, Interventions & Subgroup Calibration

Comparative Evaluation of Levers & Theoretical Models

When evaluated as a quantitative decision and mechanism ledger, the best-supported interventions and frameworks in Translational & Geroprotective Reproductive Biology are: Standard individualized ovarian stimulation with blastocyst PGT-A (Guideline — Euploidy detection ~38% in women >40; guides single embryo transfer to minimize miscarriage and multiple gestation.; landmark evidence: Standard clinical management cohorts and NGS validation studies (n=198 blastocysts; 26 studies): Remains the evidence-based benchmark standard, though it does not improve underlying oocyte biological quality.).

By contrast, interventions and hypotheses that remain experimental, subgroup-restricted, or unsupported by randomised endpoints include: Intraovarian Platelet-Rich Plasma (PRP) (Not supported — Very low-certainty evidence; transient biomarker changes (FSH/AMH) without demonstrated improvement in live birth.; Widely marketed ahead of evidence; observational improvements in AMH or menses recovery rarely translate to confirmed euploid births in controlled settings.); Noninvasive Preimplantation Genetic Testing (niPGT-A) (Trial only — 70%–85% sensitivity, 88%–92% specificity; 1.71-fold higher risk of lost live births if culture is extended to day 6.; Promising to mitigate biopsy trauma, but clinical adoption is prevented by maternal DNA contamination, high amplification failures (10%–50%), and discordant mosaicism calls.); Mitochondrial Replacement / Transfer Therapy (MRT/MST) (Trial only — Generates blastocysts and live births in selected recurrent failure cohorts; animal models show ATP rescue but inconsistent developmental progression.; Heavily restricted by legal and bioethical frameworks; autologous stem-cell sources (AUGMENT/ASCENT) lack independent blinded replication.).

Within the Tree of Knowledge, this field branches into 5 specialised sub-disciplines: Autologous Ovarian Rejuvenation Therapies (Investigates intraovarian injections of autologous platelet-rich plasma (PRP), bone marrow-derived stem cells, and cell-free secretomes or exosomes to restore folliculogenesis in diminished ovarian reserve); In Vitro Gametogenesis and Oocyte Bioengineering (Reviews experimental reconstitutions of human female germline development from induced pluripotent stem cells (iPSCs) and somatic cell nuclear transfer for advanced reproductive technology); Mitochondrial and Cytoplasmic Transfer Technologies (Examines autologous and heterologous mitochondrial transfer, germline mitochondrial replacement therapies, and cytoplasmic transfer aimed at overcoming maternal age-related metabolic and oocyte dysfunction); Preimplantation Genetic Testing and Diagnostic Biomarkers (Analyzes non-invasive and invasive preimplantation genetic testing for aneuploidy (PGT-A), cumulus cell transcriptomics, and follicular fluid biomarkers to optimize embryo selection in low-yield cycles); Senolytic and Anti-Aging Ovarian Therapeutics (Evaluates pharmacological interventions targeting senescent ovarian stromal cells, nicotinamide adenine dinucleotide (NAD+) precursors, mTOR inhibitors, and antioxidants for mitigating age-related oocyte aneuploidy).

Section III · Historical Trajectory & Contested Frontiers

Evolution of the Field, Open Debates & Active Trials

Chronologically, the field evolved through key inflection points: in 2025, First prospective cohort of mitochondrial replacement therapy in advanced maternal age and diminished ovarian reserve (Maternal spindle and pronuclear transfer were applied to 323 oocytes from 66 women aged up to 46 years with severe DOR, establishing clinical feasibility and live births while retaining maternal nuclear genetics).

Active scientific debates and unresolved methodological tensions centre on: Intraovarian PRP is heavily commercialized for ovarian rejuvenation based on small uncontrolled cohorts and biomarker shifts (AMH/FSH), whereas meta-analysis of 12 RCTs shows very low-certainty evidence with no confirmed live birth benefit. (commercial hype) Autologous mitochondrial transfer approaches (e.g. from oogonia or adipose stem cells) report preliminary live births, but animal models show ATP restoration without blastocyst improvement, and clinical reproducibility remains highly disputed. (contested) Small pilot reports claim 100% sensitivity for spent culture medium niPGT-A, but comprehensive multi-center reviews establish realistic sensitivities of 70%–85%, high discordance, and a 10%–50% amplification failure rate. (contradiction)

Section IV · Evidentiary Gaps & Research Frontiers

Open Questions & Priorities for the Next Research Sweep

Methodological priorities and open empirical questions queued for the next research sweep across Translational & Geroprotective Reproductive Biology focus on resolving subgroup effect sizes, causal mechanisms, and long-term outcomes:

  • Whether intraovarian PRP or mesenchymal stem cell instillation can stimulate true de novo folliculogenesis versus transiently altering vascularity or paracrine biomarker release (AMH/FSH).
  • Long-term nuclear-mitochondrial compatibility, heteroplasmy drift, and epigenetic safety in offspring conceived through mitochondrial replacement therapy for advanced maternal age.
  • Non-inferiority of non-invasive PGT-A using spent blastocyst culture medium compared to standard trophectoderm biopsy in randomized trials measuring cumulative live birth rates.
  • Molecular mechanisms required to overcome human stem-cell meiotic arrest and complete functional in vitro gametogenesis without catastrophic aneuploidy.
  • Multi-center RCTs evaluating autologous intraovarian PRP or stem-cell secretomes with live birth rate as the primary endpoint.
  • Non-inferiority trials comparing niPGT-A spent-medium analysis against standard trophectoderm biopsy regarding cumulative ongoing pregnancy rates.

Evidence Hierarchy (Graded Claims)

  • T1Synthesis of trials
    7 (27%)
  • T2Randomised trial
    0 (0%)
  • T3Observational, large
    4 (15%)
  • T4Observational, small or case-based
    6 (23%)
  • T5Preclinical or mechanistic
    4 (15%)
  • T6Opinion, news or unverified
    5 (19%)
4 settled17 debated5 contested / frontier

Study Designs in Indexed Literature

  • Meta-analyses, Systematic Reviews & Guidelines13 (19%)
  • Randomised Controlled Trials (RCTs)7 (10%)
  • Prospective Cohorts & Clinical Registries7 (10%)
  • Observational & Clinical Case Series3 (4%)
  • Preclinical, Cellular & Computational Models7 (10%)
  • Primary Literature & Archive Records31 (46%)

Publication Timeline Velocity

Fig. 1 — Field Evidence Architecture & Publication Trajectory. Distribution of methodological study designs (68 indexed publications) and 26 extracted claims graded from T1 (meta-analyses and guidelines) to T6.

Epistemic Verdict Distribution Across Evaluated Levers & Mechanisms (6)

Guideline1 lever (17%)
Not supported1 lever (17%)
Trial only2 levers (33%)
Weak1 lever (17%)
Lab only1 lever (17%)
Fig. 2 — Intervention & Mechanism Epistemic Calibration. Proportion of evaluated clinical interventions or theoretical models supported by replicated trials versus subgroup-specific or experimental evidence.
Primary Citations & Landmark Studies

Key Studies Anchoring This Monograph

Synthesis & Conclusions

State of the Field Conclusions

Taken together, the evidence record in Translational & Geroprotective Reproductive Biology (68 primary sources, 26 graded claims, highest certainty T1 — Synthesis of trials) separates replicated high-tier findings from early-stage hypotheses. The most robust actionable levers supported by current evidence are Standard individualized ovarian stimulation with blastocyst PGT-A (Euploidy detection ~38% in women >40; guides single embryo transfer to minimize miscarriage and multiple gestation.). The 8 open research priorities detailed above guide the next autonomous literature and clinical trial sweep.

Key Quantitative Takeaways

  • 37.7%–38.5%: Blastocyst euploidy rate in women aged 39 to older than 40 undergoing NGS trophectoderm biopsy (Claim 10 (2015 cohort)).
  • 9–12 MII oocytes: Threshold of mature oocytes required to achieve optimal cumulative live birth rates in autologous IVF at age >=35 (Claim 9 (2023 cohort)).
  • Standard individualized ovarian stimulation with blastocyst PGT-A [Guideline]: Euploidy detection ~38% in women >40; guides single embryo transfer to minimize miscarriage and multiple gestation. — Remains the evidence-based benchmark standard, though it does not improve underlying oocyte biological quality.
  • Intraovarian Platelet-Rich Plasma (PRP) [Not supported]: Very low-certainty evidence; transient biomarker changes (FSH/AMH) without demonstrated improvement in live birth. — Widely marketed ahead of evidence; observational improvements in AMH or menses recovery rarely translate to confirmed euploid births in controlled settings.
  • Open frontier in Translational & Geroprotective Reproductive Biology: Whether intraovarian PRP or mesenchymal stem cell instillation can stimulate true de novo folliculogenesis versus transiently altering vascularity or paracrine biomarker release (AMH/FSH).
37.7%–38.5%

Blastocyst euploidy rate in women aged 39 to older than 40 undergoing NGS trophectoderm biopsy

Claim 10 (2015 cohort)

9–12 MII oocytes

Threshold of mature oocytes required to achieve optimal cumulative live birth rates in autologous IVF at age >=35

Claim 9 (2023 cohort)

12 RCTs (n=1,069)

Evidence base demonstrating very low-certainty evidence for live birth and miscarriage benefit with intraovarian PRP

Claim 2 (2024/2021 systematic review)

10%–50%

DNA amplification failure rate observed in noninvasive spent culture medium PGT-A

Claim 23 (2025 review)

Where each lever applies

A graded decision ledger of interventions across clinical subgroups. Each row names its best landmark evidence, measured effect, clinical reading, and epistemic verdict.

Supported: RCT live-birth gainTargeted: specific subgroupGuideline: clinical consensusWeak: inconsistent/unproven gainNot supported: RCTs show no gainTrial: human trial in progressLab: preclinical / cell dish

Preparation & Transfer

Lever & MechanismBest Landmark EvidenceMeasured Effect & Clinical ReadingVerdict
Standard individualized ovarian stimulation with blastocyst PGT-A

Optimized gonadotropin dosing combined with trophectoderm biopsy and euploid single embryo transfer.

Standard clinical management cohorts and NGS validation studies (n=198 blastocysts; 26 studies)

Effect: Euploidy detection ~38% in women >40; guides single embryo transfer to minimize miscarriage and multiple gestation.

Clinical reading: Remains the evidence-based benchmark standard, though it does not improve underlying oocyte biological quality.

Guideline

Ovarian adjuncts

Lever & MechanismBest Landmark EvidenceMeasured Effect & Clinical ReadingVerdict
Intraovarian Platelet-Rich Plasma (PRP)

Direct injection of autologous platelet concentrate into ovarian stroma to activate dormant follicles.

Systematic review of 12 RCTs (n=1,069 women undergoing ART)

Effect: Very low-certainty evidence; transient biomarker changes (FSH/AMH) without demonstrated improvement in live birth.

Clinical reading: Widely marketed ahead of evidence; observational improvements in AMH or menses recovery rarely translate to confirmed euploid births in controlled settings.

Not supported
In Vitro Activation (IVA) & Mechanical Hippo Disruption

Laparoscopic ovarian cortical incision or fragmentation with drug incubation to stimulate follicle growth.

Clinical series in poor ovarian responders and primary ovarian insufficiency

Effect: Variable transient follicular recruitment; unpredictable blastocyst competence and high surgical invasiveness.

Clinical reading: Mechanistically grounded in Hippo pathway disruption, but patient yield is low and clinical applicability in women over 40 is limited.

Weak

Embryo selection

Lever & MechanismBest Landmark EvidenceMeasured Effect & Clinical ReadingVerdict
Noninvasive Preimplantation Genetic Testing (niPGT-A)

Analysis of cell-free embryonic DNA in spent blastocyst culture medium to avoid invasive trophectoderm biopsy.

Prospective cohort studies (220 blastocysts; concordance evaluations against ICM)

Effect: 70%–85% sensitivity, 88%–92% specificity; 1.71-fold higher risk of lost live births if culture is extended to day 6.

Clinical reading: Promising to mitigate biopsy trauma, but clinical adoption is prevented by maternal DNA contamination, high amplification failures (10%–50%), and discordant mosaicism calls.

Trial only

Cellular & Nuclear

Lever & MechanismBest Landmark EvidenceMeasured Effect & Clinical ReadingVerdict
Mitochondrial Replacement / Transfer Therapy (MRT/MST)

Maternal spindle transfer into enucleated donor oocytes or autologous stem-cell mitochondrial microinjection during ICSI.

Prospective cohort of 66 patients (323 mature oocytes) and small autologous series (52 patients, 13 live births)

Effect: Generates blastocysts and live births in selected recurrent failure cohorts; animal models show ATP rescue but inconsistent developmental progression.

Clinical reading: Heavily restricted by legal and bioethical frameworks; autologous stem-cell sources (AUGMENT/ASCENT) lack independent blinded replication.

Trial only
In Vitro Gametogenesis (IVG)

Generation of functional gametes from induced pluripotent stem cells or somatic cell nuclear reprogramming.

Systematic reviews of 23 primate studies and murine reconstitution protocols

Effect: Reconstituted in mice; human and non-human primate protocols achieve <1% meiotic entry with zero viable human oocytes to date.

Clinical reading: A long-term scientific frontier that completely circumvents reproductive aging if solved, but decades away from clinical application.

Lab only

Questions for specialist consultations

High-yield clinical and laboratory inquiries directly derived from the evidence record.

  1. What is the clinic's verifiable, age-stratified live birth rate per started cycle for autologous IVF in patients aged 40 and older?
  2. Are regenerative add-ons such as intraovarian PRP or mitochondrial transfer offered as commercial out-of-pocket procedures or strictly within an IRB-approved randomized controlled trial?
  3. How does the embryo laboratory manage diagnostic mosaicism and segmental aneuploidy calls from NGS PGT-A before discarding or transferring borderline embryos?
  4. Does the clinic utilize non-invasive spent-medium DNA testing (niPGT-A), and what protocol exists to manage the high rate of amplification failure and culture-timing risks?

Queued for next research sweep

Frontier clinical trials, emerging biology, and targeted subgroup outcomes tracked by the autonomous research worker.

  • Multi-center RCTs evaluating autologous intraovarian PRP or stem-cell secretomes with live birth rate as the primary endpoint.
  • Non-inferiority trials comparing niPGT-A spent-medium analysis against standard trophectoderm biopsy regarding cumulative ongoing pregnancy rates.
  • Long-term developmental and epigenetic follow-up data from children born via maternal spindle transfer and pronuclear transfer.
  • Advances in overcoming primate and human primordial germ cell-like meiotic arrest (<1% meiotic entry) in stem-cell gametogenesis.
Historical timeline (1 milestone, 2025–2025)
  1. 2025

    First prospective cohort of mitochondrial replacement therapy in advanced maternal age and diminished ovarian reserve

    Maternal spindle and pronuclear transfer were applied to 323 oocytes from 66 women aged up to 46 years with severe DOR, establishing clinical feasibility and live births while retaining maternal nuclear genetics.

Evidence by study design (26 findings across T1–T6)

Strongest support first. The bar beside each finding shows its grade.

Synthesis of trials

  1. #1 In vitro gametogenesis has enabled meiotic entry from primate pluripotent stem cells and fetal germ cells across 23 studies, but functional primate oogenesis to full maturity remains unachieved unlike in murine models.

    Through In Vitro Gametogenesis — Young Stem Cells (2025); Human and non-human primate female in vitro gametogenesis toward mei… (2025); The Stage of Differentiation Into Mature Gametes During Gametogenesi… (2025); In vitro gametogenesis: Towards competent oocytes (2024); and 2 more

    Generating de novo oocytes from stem cells is a primary frontier for age-related exhaustion of the ovarian reserve, but primate meiotic progression remains a technical barrier.

  2. #2 Next-generation sequencing-based PGT-A that incorporates segmental imbalance and mosaicism prediction displays significantly higher diagnostic discordance upon blastocyst reanalysis across 1,271 embryos and 2,260 pairwise comparisons from 26 studies.

    DebatedPreimplantation genetic testing for aneuploidy: A review of publishe… (2020)

    Diagnostic concordance in PGT-A is critical for patients aged 40 and older to avoid discarding viable embryos incorrectly classified as abnormal.

  3. #3 In women undergoing assisted reproduction, autologous platelet-rich plasma (PRP) evaluated across 12 RCTs (n=1,069) provides very low-certainty evidence for outcomes such as live birth and miscarriage, indicating that clinical implementation for ovarian rejuvenation remains premature.

    Marketed ahead of evidenceAutologous platelet-rich plasma for assisted reproduction (2024); Multichannel Recovery Potential with Activated Autologous Intraovari… (2023); Intraovarian injection of platelet-rich plasma in assisted reproduct… (2021); Effects of Intraovarian Platelet Rich Plasma in Women With Poor Ovar… (2020)

    Autologous PRP is aggressively commercialized for ovarian rejuvenation despite lacking robust clinical trial evidence to verify efficacy and safety.

  4. #4 Cellular senescence in ovarian cell types contributes to female reproductive aging, and senotherapeutic interventions are under active investigation to eliminate senescent cells and extend reproductive longevity.

    DebatedExploration of the mechanism and therapy of ovarian aging by targeti… (2025); The role of cellular senescence in ovarian aging (2024); The role of cellular senescence in female reproductive aging and the… (2021)

    While senescent cell accumulation is established in reproductive aging, targeting senescent cells with senolytics remains largely experimental in animal models and requires human clinical verification.

  5. #5 Reproductive aging alters AMH, VEGF, IGF1, and mitochondrial signaling pathways in follicles, while experimental interventions including coenzyme Q10, DHEA, mitochondrial rescue, and senolytic clearance are under exploration to sustain aged follicular function.

    DebatedMetabolic, epigenetic, and immune crosstalk in ovarian aging (2026); Age-related changes in Folliculogenesis and potential modifiers to i… (2022)

    Elucidating molecular changes in ovarian aging allows targeted pharmacological and mitochondrial interventions for advanced reproductive age.

  6. #6 Regenerative interventions such as intraovarian platelet-rich plasma (PRP) and hydrogel-encapsulated mesenchymal stem cells (MSCs) are under clinical investigation to restore folliculogenesis, enhance anti-Müllerian hormone levels, and improve oocyte retrieval in diminished ovarian reserve and ovarian insufficiency.

    DebatedHydrogel-Based Autologous Stem Cell Therapy for Ovarian Rejuvenation… (2026); P-672 Intraovarian Platelet-Rich Plasma (PRP) In Women With Ovarian … (2025); Intraovarian Platelet-Rich Plasma Therapy for PCOS: Unanswered Quest… (2025)

    While early clinical trials and pilot studies show biological signals of dormant follicle activation and improved ART parameters, large-scale randomized trial confirmation remains pending.

  7. #7 Postponing blastocyst culture medium collection to day 6 for noninvasive genetic testing may reduce clinical efficacy, with meta-analytic evidence indicating a 1.71-fold higher risk of lost live births compared to day 5 transfers.

    DebatedNoninvasive preimplantation genetic testing for aneuploidies (niPGT-… (2020)

    Delaying transfer or vitrification to harvest higher amounts of embryonic cell-free DNA can conflict with clinical implantation potential.

Observational, large

  1. #8 Noninvasive PGT-A using blastocyst spent culture medium demonstrated an 82.9% overall concordance rate (121/146) with trophectoderm biopsy and a 70.0% true negative rate (7/10) relative to inner cell mass results in embryos with trophectoderm-positive aneuploidy.

    DebatedNoninvasive preimplantation genetic testing for aneuploidy using bla… (2025)

    Noninvasive testing offers an alternative to invasive trophectoderm biopsy, reducing cellular stress on blastocysts from older patients.

  2. #9 Next-generation sequencing of trophectoderm biopsies in 198 blastocysts identified euploidy rates of 37.7% in women aged 39-40 years and 38.5% in women older than 40 years, compared to 41.9% to 47.8% in women under 38.

    Next generation sequencing for preimplantation genetic testing of bl… (2015)

    High-resolution next-generation sequencing provides diagnostic accuracy for age-related embryonic aneuploidy, a primary obstacle to successful pregnancy in women over 40.

  3. #10 In women aged 35 and older undergoing autologous IVF, achieving optimal cumulative live birth rates requires approximately 9 to 12 metaphase II (MII) oocytes or 10 to 11 embryos, with maternal age of 42 years or older identified as a clinical threshold for increased risk of adverse outcomes.

    The Prediction of IVF Outcomes with Autologous Oocytes and the Optim… (2023)

    Quantifying required oocyte and embryo yields provides realistic benchmarks for prognosis and clinical counseling in advanced maternal age autologous IVF cycles.

  4. #11 Intraovarian platelet-rich plasma (PRP) administration in 469 women with infertility, hormonal abnormalities, amenorrhoea, or premature ovarian failure was associated with statistically significant increases in normal FSH and E2 values at 3 and 4 months post-intervention.

    DebatedIntraovarian Platelet-Rich Plasma Injections: Safety and Thoughts on… (2023)

    Intraovarian PRP is actively investigated as an experimental ovarian rejuvenation modality, though robust randomized controlled trial evidence is still required before routine clinical implementation.

Observational, small or case-based

  1. #12 In a prospective multicenter evaluation of 220 blastocysts using spent culture medium cell-free DNA from couples aged 20 to 44 (mean age 38 years), 36.4% were classified as euploid, 31.3% as aneuploid, and 32.3% as mosaic, with mosaicism rates remaining between 29.8% and 33.8% across age groups.

    DebatedRelationship between age and blastocyst chromosomal ploidy analyzed … (2020)

    Determining embryonic mosaicism noninvasively is critical for clinical decision-making in advanced reproductive age, though high mosaicism detection rates raise concerns regarding false-positive cell-free DNA signals.

  2. #13 Autologous mitochondrial transfer from oogonia stem cells into mature oocytes during intracytoplasmic sperm injection improved embryo quality and resulted in 13 live births without genetic alteration in 52 patients with recurrent IVF failure.

    ContestedMitochondrial Transfer into Human Oocytes Improved Embryo Quality an… (2023)

    Mitochondrial augmentation seeks to reverse mitochondrial dysfunction in aging oocytes, but efficacy and long-term safety require rigorous randomized trial validation.

  3. #14 Mitochondrial replacement therapy via pronuclear and maternal spindle transfer into donor oocytes yielded successful fertilization, blastocyst euploidy, and live births in a prospective cohort of 66 patients with diminished ovarian reserve and advanced maternal age up to 46 years across 323 mature oocytes.

    DebatedO-068 Mitochondrial replacement therapy effectively enhances embryo … (2025)

    MRT represents a frontier intervention to bypass maternal age-related cytoplasmic and mitochondrial deterioration, though ethical and technical debates persist.

  4. #15 Autologous intraovarian platelet-rich plasma (PRP) infusion in a pilot study of 120 women significantly improved anti-Müllerian hormone levels and antral follicle counts, leading to menstruation recovery in 18 of 30 women with premature ovarian insufficiency and 13 of 30 menopausal women.

    ContestedReactivating Ovarian Function through Autologous Platelet-Rich Plasm… (2020)

    Intraovarian PRP is an emerging intervention showing preliminary clinical activity, but large randomized controlled trials are needed before adoption into standard reproductive care.

  5. #16 Noninvasive preimplantation genetic testing for aneuploidies using cell-free DNA from spent culture medium achieved full concordance with whole-embryo karyotyping at 24 hours of culture in vitro, but concordance drops markedly at shorter culture intervals or in early blastocysts.

    DebatedConditions for improved accuracy of noninvasive preimplantation gene… (2024); Noninvasive preimplantation genetic testing for aneuploidy (2023)

    Noninvasive testing aims to replace invasive trophectoderm biopsy to prevent procedural damage to fragile embryos, but optimal culture timing and diagnostic concordance remain inconsistent across laboratories.

  6. #17 Autologous platelet-rich plasma gel used during orthotopic reimplantation of cryopreserved ovarian tissue in 5 patients (aged up to 41 years) showed no surgical complications, restored menses at a median of 3 months, and resulted in 1 live birth compared to 19 historical controls.

    DebatedOvarian Tissue Transplantation Using Autologous Platelet-Rich Plasma… (2026)

    Biological adjuvants like autologous PRP are investigated as minimally invasive options to facilitate ovarian rejuvenation and follicular restoration in aging or depleted ovarian tissue.

Preclinical or mechanistic

  1. #18 Clinical management of advanced maternal age in IVF relies on individualized controlled ovarian stimulation, preimplantation genetic testing for aneuploidies, and single embryo transfer, alongside experimental strategies such as nuclear or mitochondrial transfer.

    Advanced Maternal Age in IVF: Still a Challenge? The Present and the… (2019)

    Standard assisted reproductive technologies mitigate age-related aneuploidy and low response, while experimental therapies aim to directly restore oocyte competence.

  2. #19 Noninvasive preimplantation genetic testing (niPGT-A) using spent blastocyst culture medium demonstrated 100% sensitivity and a lower false-positive rate compared with initial trophectoderm biopsy when validated against inner cell mass karyotypes across 26 re-analyzed blastocysts.

    ContestedDiagnostic efficiency of blastocyst culture medium in noninvasive pr… (2020)

    Improving noninvasive embryo selection is critical for older women who yield fewer viable embryos and risk biopsy-related trauma.

  3. #20 In aged hamster oocytes exhibiting a 35.4% reduction in ATP and a 51.8% drop in mitochondrial DNA, autologous platelet mitochondrial microinjection significantly restored ATP production but did not improve progression to the blastocyst stage.

    DebatedAge-Related Hamster Mitochondrial Changes and Oocyte Changes Followi… (2019)

    Mitochondrial supplementation represents a frontier therapeutic concept to reverse oocyte metabolic decline in advanced age, yet energetic restoration does not automatically translate into improved preimplantation development.

  4. #21 Autologous mitochondrial transfer from stem cell sources—including adipose-derived stem cells (ASCENT) and urine-derived stem cells (USC)—improves mitochondrial activity, calcium dynamics, embryonic morphological indicators, and euploidy rates in oocytes and early embryos from women with advanced age or infertility.

    DebatedAdipose Stem Cell Mitochondrial Transplantation in ART: From Biologi… (2026); Autologous non-invasively derived stem cells mitochondria transfer s… (2023)

    Autologous mitochondrial augmentation bypasses ethical and heterologous mtDNA limitations, representing an emerging frontier strategy to treat age-related oocyte incompetence.

Opinion, news or unverified

  1. #22 Noninvasive preimplantation genetic testing of cell-free DNA achieves 70% to 85% sensitivity and 88% to 92% specificity with 10% to 50% amplification failure rates, and lacks randomized controlled trial validation for clinical adoption.

    DebatedNoninvasive Preimplantation Genetic Testing in Recurrent Pregnancy L… (2025)

    Noninvasive aneuploidy testing aims to reduce biopsy trauma in vulnerable embryos from older patients, but high failure rates and discordance limit current reliability.

  2. #23 Autologous mitochondrial transfer approaches aimed at restoring oocyte ATP levels and developmental competence in advanced reproductive age have yielded controversial clinical results.

    ContestedNew Frontiers in IVF: mtDNA and autologous germline mitochondrial en… (2019); Autologous mitochondrial microinjection; a strategy to improve the o… (2019)

    While augmenting mitochondrial mass in aged oocytes has sound biological rationale, clinical efficacy and safety of autologous germline mitochondrial transfers are heavily disputed.

  3. #24 Adult stem cell therapies show regenerative potential for ovarian and endometrial tissue in female reproductive disorders, but translational efficacy remains limited by preclinical reliance and unstandardized delivery methods.

    DebatedStem cell treatments for female reproductive disorders: a comprehens… (2025)

    Stem cell-based rejuvenation requires standardized delivery and robust human trials before clinical deployment can be justified.

  4. #25 Mechanical interventions including in vitro activation (IVA) combining tissue fragmentation with pharmacological agents, and whole ovary laparoscopic incision (WOLI), enhance ovarian folliculogenesis in aging women with poor ovarian response or primary ovarian insufficiency.

    DebatedFacilitation of Ovarian Response by Mechanical Force—Latest Insight … (2023)

    Mechanical ovarian disruption alters Hippo signaling and ovarian stiffness to activate dormant follicles in depleted ovarian reserves.

  5. #26 Transfer of autologous mitochondria sourced from fully grown oocytes obtained via in vitro follicle activation or surplus immature oocytes offers a potential approach to enhance oocyte quality and blastocyst competence.

    DebatedImproving oocyte quality by transfer of autologous mitochondria from… (2017)

    Autologous ooplasmic or mitochondrial supplementation using germline-derived sources has been proposed to overcome age-related cytoplasmic deficiency without allogeneic genetic mixing.

Where the record disagrees (3 controversies)

  • Intraovarian PRP is heavily commercialized for ovarian rejuvenation based on small uncontrolled cohorts and biomarker shifts (AMH/FSH), whereas meta-analysis of 12 RCTs shows very low-certainty evidence with no confirmed live birth benefit.

    Findings #3, #11, #15

  • Autologous mitochondrial transfer approaches (e.g. from oogonia or adipose stem cells) report preliminary live births, but animal models show ATP restoration without blastocyst improvement, and clinical reproducibility remains highly disputed.

    Findings #13, #20, #21, #23

  • Small pilot reports claim 100% sensitivity for spent culture medium niPGT-A, but comprehensive multi-center reviews establish realistic sensitivities of 70%–85%, high discordance, and a 10%–50% amplification failure rate.

    Findings #2, #8, #19, #22

Node lineage & crossover disciplines

Parent lineage, active node, direct child sub-branches, and associated crossover disciplines across the Tree of Knowledge.

Hierarchy:
Natural & Life SciencesMedicine, Health & LongevityReproductive Medicine & Human FertilityAdvanced Maternal Age & Pregnancy After 40Translational & Geroprotective Reproductive BiologyAutologous Ovarian Rejuvenation TherapiesIn Vitro Gametogenesis and Oocyte BioengineeringMitochondrial and Cytoplasmic Transfer TechnologiesPreimplantation Genetic Testing and Diagnostic BiomarkersSenolytic and Anti-Aging Ovarian Therapeutics
+ Associated nodes:
Antioxidants (intersects) Mitochondrial Medicine (intersects)
  • + intersects Antioxidants — Shared mechanisms, study designs, or quantitative benchmarks between Antioxidants and Mitochondrial Bioenergetics and Targeted Antioxidants.
  • + intersects Mitochondrial Medicine — Shared mechanisms, study designs, or quantitative benchmarks between Mitochondrial Medicine and NAD+ Biosynthetic Pathways and Sirtuin Activation.

Branches

  • Autologous Ovarian Rejuvenation Therapies Investigates intraovarian injections of autologous platelet-rich plasma (PRP), bone marrow-derived stem cells, and cell-free secretomes or exosomes to restore folliculogenesis in diminished ovarian reserve.
  • In Vitro Gametogenesis and Oocyte Bioengineering Reviews experimental reconstitutions of human female germline development from induced pluripotent stem cells (iPSCs) and somatic cell nuclear transfer for advanced reproductive technology.
  • Mitochondrial and Cytoplasmic Transfer Technologies Examines autologous and heterologous mitochondrial transfer, germline mitochondrial replacement therapies, and cytoplasmic transfer aimed at overcoming maternal age-related metabolic and oocyte dysfunction.
  • Preimplantation Genetic Testing and Diagnostic Biomarkers Analyzes non-invasive and invasive preimplantation genetic testing for aneuploidy (PGT-A), cumulus cell transcriptomics, and follicular fluid biomarkers to optimize embryo selection in low-yield cycles.
  • Senolytic and Anti-Aging Ovarian Therapeutics Evaluates pharmacological interventions targeting senescent ovarian stromal cells, nicotinamide adenine dinucleotide (NAD+) precursors, mTOR inhibitors, and antioxidants for mitigating age-related oocyte aneuploidy.
AI Tree OrganiserExpand Translational & Geroprotective Reproductive Biology

Branches are never named or placed manually. Ask any scientific question — AI decomposes multi-part inquiries into one, two, three, or more canonical sub-branches and places each under its proper discipline.

Public archive: please keep questions to general scientific concepts (no names, dates of birth, or personal health identifiers). Privacy & copyright.

Auto-classifies taxonomy & cross-links
Primary indexed sources (68)

Primary scientific literature, systematic reviews, and clinical trial registrations indexed for this branch.

  1. Mesenchymal stem cell therapy for premature ovarian insufficiency: progress and challenges — Zhuyan Shao, Leilei Liang, Yite Xue et al. Journal of Ovarian Research, 2026, expert opinion, 5 citations · DOI: 10.1186/s13048-026-01976-4
  2. Metabolic, epigenetic, and immune crosstalk in ovarian aging — Jing Li, Qianhui Liao, Yan Yang et al. iScience, 2026, expert opinion, 4 citations · DOI: 10.1016/j.isci.2026.114733
  3. Ovarian Tissue Transplantation Using Autologous Platelet-Rich Plasma: A Pilot Clinical Trial — Rossella Vicenti, Marisol Doglioli, Antonio Raffone et al. Journal of Minimally Invasive Gynecology, 2026, cohort, 1 citations · DOI: 10.1016/j.jmig.2026.01.061
  4. Hydrogel-Based Autologous Stem Cell Therapy for Ovarian Rejuvenation: A Systematic Review of Regenerative Approaches for Premature Ovarian Insufficiency — Mr. Ayush Kishorkumar Rana, Dhwani Gandhi PAIN JOINTS SPINE, 2026, systematic review · DOI: 10.1922/pjs.16.4s.2026.666
  5. Research progress on multi-mechanism analysis and protection strategies of ovarian aging and fertility decline — Jianhui Chen, Xiaohui Duan, Yaling Jing et al. Journal of Ovarian Research, 2026, expert opinion · DOI: 10.1186/s13048-026-02203-w
  6. Adipose Stem Cell Mitochondrial Transplantation in ART: From Biological Rationale to Clinical Milestone — Helaruwan Pasan Kumara Wijethunga Arachchilage, Udayanga Sanath Kankanam Gamage, Atsushi Morimoto et al. Cells, 2026, systematic review · DOI: 10.3390/cells15161438
  7. Exploration of the mechanism and therapy of ovarian aging by targeting cellular senescence — Weicheng Tang, Kaichen Wang, Yourong Feng et al. Life Medicine, 2025, expert opinion, 30 citations · DOI: 10.1093/lifemedi/lnaf004
  8. Artificial Gametogenesis and In Vitro Spermatogenesis: Emerging Strategies for the Treatment of Male Infertility. — Kaltsas A, Kyrgiafini MA, Markou E et al. International journal of molecular sciences, 2025, systematic review, 13 citations · DOI: 10.3390/ijms26157383
  9. Mesenchymal Stem Cells: A Therapeutic Approach in Fertility Restoration in Premature Ovarian Insufficiency — Nourhan Hassan, Donia Mohamed Hussein, Fady Ashraf Malak et al. Stem Cell Reviews and Reports, 2025, expert opinion, 12 citations · DOI: 10.1007/s12015-025-10944-2
  10. Stem cell treatments for female reproductive disorders: a comprehensive review — Ramya Nair, Prachi Agarwal, Mrunmayi Ashish Gadre et al. Journal of Ovarian Research, 2025, expert opinion, 9 citations · DOI: 10.1186/s13048-025-01750-y
  11. Noninvasive preimplantation genetic testing for aneuploidy using blastocyst spent culture medium may serve as a backup of trophectoderm biopsy in conventional preimplantation genetic testing — Songchang Chen, Li Wang, Yuting Hu et al. BMC Medical Genomics, 2025, in vitro, 7 citations · DOI: 10.1186/s12920-025-02106-7
  12. Human and non-human primate female in vitro gametogenesis toward meiotic entry: a systematic review — Sylwia M. Czukiewska, Celine M. Roelse, Susana M. Chuva de Sousa Lopes Fertility and Sterility, 2025, systematic review, 7 citations · DOI: 10.1016/j.fertnstert.2025.04.040
  13. Female germline stem cells: recent advances, opportunities, and challenges to overcome — Yao-Qi Huang, Haifeng Ye Cell Regeneration, 2025, expert opinion, 6 citations · DOI: 10.1186/s13619-025-00256-8
  14. In vitro maturation of bovine and porcine oocytes as a versatile model for toxicity and metabolism studies — Ida Hallberg, Denise Laskowski, Ylva Cecilia Björnsdotter Sjunnesson Biology of Reproduction, 2025, systematic review, 6 citations · DOI: 10.1093/biolre/ioaf137
  15. Noninvasive Preimplantation Genetic Testing in Recurrent Pregnancy Loss and Implantation Failure: Breakthrough or Overpromise? — Grzegorz Mrugacz, Aleksandra Mospinek, Joanna Głowacka et al. Cells, 2025, systematic review, 3 citations · DOI: 10.3390/cells14201591
  16. O-068 Mitochondrial replacement therapy effectively enhances embryo quality and pregnancy outcomes in patients with advanced maternal age and diminished ovarian reserve — Y Misyura, Birol Aydin, Ulyana Dorofeyeva et al. Human Reproduction, 2025, cohort, 2 citations · DOI: 10.1093/humrep/deaf097.068
  17. The Stage of Differentiation Into Mature Gametes During Gametogenesis in Vitro — Jaba Tkemaladze Longevity Horizon, 2025, expert opinion, 1 citations · DOI: 10.65649/32f1681d
  18. P-672 Intraovarian Platelet-Rich Plasma (PRP) In Women With Ovarian Insufficiency – A Single Centre’s Experience — Michelle Jia Min Loh, Keng Yean Wong, Chee Wai Ku et al. Human Reproduction, 2025, case series, 1 citations · DOI: 10.1093/humrep/deaf097.978
  19. Through In Vitro Gametogenesis — Young Stem Cells — Jaba Tkemaladze Longevity Horizon, 2025, expert opinion, 1 citations · DOI: 10.65649/9909a9ee
  20. Intraovarian Platelet-Rich Plasma Therapy for PCOS: Unanswered Questions and Future Research Directions — Zaher O Merhi Journal of Clinical Medicine, 2025, expert opinion, 1 citations · DOI: 10.3390/jcm14248845
  21. Ovarian microenvironment: challenges and opportunities in protecting against chemotherapy-associated ovarian damage — Yican Guo, Liru Xue, Weicheng Tang et al. Human Reproduction Update, 2024, unknown, 121 citations · DOI: 10.1093/humupd/dmae020
  22. Targeting Cell Senescence and Senolytics: Novel Interventions for Age-Related Endocrine Dysfunction — Masayoshi Suda, Karl H Paul, Utkarsh Tripathi et al. Endocrine Reviews, 2024, expert opinion, 78 citations · DOI: 10.1210/endrev/bnae010
  23. The role of cellular senescence in ovarian aging — Jéssica D. Hense, José V.V. Isola, Driele Neske Garcia et al. npj Aging, 2024, expert opinion, 52 citations · DOI: 10.1038/s41514-024-00157-1
  24. Current Status and Future Prospects of Stem Cell Therapy for Infertile Patients with Premature Ovarian Insufficiency — Hye Kyeong Kim, Tae Jin Kim Biomolecules, 2024, expert opinion, 38 citations · DOI: 10.3390/biom14020242
  25. Autologous platelet-rich plasma for assisted reproduction — Dennis Vaidakis, Michail Papapanou, Charalampos S. Siristatidis Cochrane Database of Systematic Reviews, 2024, meta analysis, 36 citations · DOI: 10.1002/14651858.cd013875.pub2
  26. In vitro gametogenesis: Towards competent oocytes — Eishi Aizawa, Antoine H.F.M. Peters, Anton Wutz BioEssays, 2024, systematic review, 10 citations · DOI: 10.1002/bies.202400106
  27. Conditions for improved accuracy of noninvasive preimplantation genetic testing for aneuploidy: Focusing on the zona pellucida and early blastocysts — Hiroki Takeuchi, Midori Morishita, Midori Uemura et al. Reproductive Medicine and Biology, 2024, in vitro, 5 citations · DOI: 10.1002/rmb2.12604
  28. The role of exosomal microRNAs in ovarian metabolism and aging using mice as a menopause model. — Bianka M. Zanini LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas), 2024
  29. The role of platelet-rich plasma in the world of fertility use of platelet-rich plasma in the endometrium : inicial of clinical trials — Sandra Sousa Moreira Lusophone University Repository, 2024
  30. Mitochondrial Transfer into Human Oocytes Improved Embryo Quality and Clinical Outcomes in Recurrent Pregnancy Failure Cases — Yoshiharu Morimoto, Udayanga Sanath Kankanam Gamage, Takayuki Yamochi et al. International Journal of Molecular Sciences, 2023, cohort, 60 citations · DOI: 10.3390/ijms24032738
  31. Biological therapies for premature ovarian insufficiency: what is the evidence? — Melpomeni Moustaki, Adamantia Kontogeorgi, Gkalia Tsangkalova et al. Frontiers in Reproductive Health, 2023, expert opinion, 26 citations · DOI: 10.3389/frph.2023.1194575
  32. In Vitro Gametogenesis in Oncofertility: A Review of Its Potential Use and Present-Day Challenges in Moving toward Fertility Preservation and Restoration — Victoria G. Wesevich, Christopher Ke Arkfeld, David B. Seifer Journal of Clinical Medicine, 2023, expert opinion, 20 citations · DOI: 10.3390/jcm12093305
  33. The Prediction of IVF Outcomes with Autologous Oocytes and the Optimal MII Oocyte/Embryo Number for Live Birth at Advanced Maternal Age — Jelena Havrljenko, Vesna Kopitović, Aleksandra Trninić-Pjević et al. Medicina, 2023, cohort, 20 citations · DOI: 10.3390/medicina59101799
  34. Intraovarian Platelet-Rich Plasma Injections: Safety and Thoughts on Efficacy Based on a Single Centre Experience With 469 Women. — Fraidakis M, Giannakakis G, Anifantaki A et al. Cureus, 2023, cohort, 17 citations · DOI: 10.7759/cureus.38674
  35. Thrombocytes and Platelet-Rich Plasma as Modulators of Reproduction and Fertility — Bernadett Nagy, Kálmán András Kovács, Endre Sulyok et al. International Journal of Molecular Sciences, 2023, expert opinion, 16 citations · DOI: 10.3390/ijms242417336
  36. Autologous non-invasively derived stem cells mitochondria transfer shows therapeutic advantages in human embryo quality rescue. — Jiang Z, Shi C, Han H et al. Biological research, 2023, in vitro, 14 citations · DOI: 10.1186/s40659-023-00470-1
  37. Facilitation of Ovarian Response by Mechanical Force—Latest Insight on Fertility Improvement in Women with Poor Ovarian Response or Primary Ovarian Insufficiency — Chia Lin Chang International Journal of Molecular Sciences, 2023, expert opinion, 14 citations · DOI: 10.3390/ijms241914751
  38. Autologous Human Mesenchymal Stem Cell-Based Therapy in Infertility: New Strategies and Future Perspectives — Zahirrah Begam Mohamed Rasheed, Fazlina Nordin, Wan Safwani Wan Kamarul Zaman et al. Biology, 2023, expert opinion, 13 citations · DOI: 10.3390/biology12010108
  39. Cell-free deoxyribonucleic acid analysis in preimplantation genetic testing — Carmen María García-Pascual, Luis Navarro-Sánchez, Ianae Ichikawa Ceschin et al. F&S Science, 2023, expert opinion, 6 citations · DOI: 10.1016/j.xfss.2023.01.001
  40. Multichannel Recovery Potential with Activated Autologous Intraovarian Platelet-Rich Plasma and Its Derivatives — Eric Scott Sills, Samuel H. Wood Medicines, 2023, expert opinion, 2 citations · DOI: 10.3390/medicines10070040
  41. Effect of noninvasive embryo viability testing versus conventional IVF on the live birth rate in IVF/ICSI patients: a study protocol for a double-blind, multicenter, randomized controlled trial — Yanfei Cheng, Cuilian Zhang, Yun Liu et al. BMC Pregnancy and Childbirth, 2023, rct, 2 citations · DOI: 10.1186/s12884-023-05892-z
  42. Noninvasive preimplantation genetic testing for aneuploidy — Olga I. Lisitsyna, А.Н. Екимов, Е. Е. Атапина et al. Bulletin of Russian State Medical University, 2023, case series · DOI: 10.24075/brsmu.2023.034
  43. Epigenetic regulation of aging: implications for interventions of aging and diseases — Wang Kang, Huicong Liu, Qinchao Hu et al. Signal Transduction and Targeted Therapy, 2022, unknown, 669 citations · DOI: 10.1038/s41392-022-01211-8
  44. Age-related changes in Folliculogenesis and potential modifiers to improve fertility outcomes - A narrative review — Ecem Esencan, Gabriela Beroukhim, David B. Seifer Reproductive Biology and Endocrinology, 2022, systematic review, 62 citations · DOI: 10.1186/s12958-022-01033-x
  45. Autologous Platelet-rich Plasma (PRP) Infusion to Improve Outcomes in Women With Ovarian Insufficiency: a Pilot Study KK Women's and Children's Hospital, 2022, rct
  46. The role of cellular senescence in female reproductive aging and the potential for senotherapeutic interventions — Laura E. Secomandi, Michela Borghesan, Michael C. Velarde et al. Human Reproduction Update, 2021, systematic review, 207 citations · DOI: 10.1093/humupd/dmab038
  47. Intraovarian injection of platelet-rich plasma in assisted reproduction: too much too soon? — Atkinson L, Martin F, Sturmey RG Human reproduction (Oxford, England), 2021, expert opinion, 66 citations · DOI: 10.1093/humrep/deab106
  48. Autologous Intraovarian Platelet Rich Plasma Treatment in Women With Poor Ovarian Response Nadezhda Women's Health Hospital, 2021, rct
  49. Reactivating Ovarian Function through Autologous Platelet-Rich Plasma Intraovarian Infusion: Pilot Data on Premature Ovarian Insufficiency, Perimenopausal, Menopausal, and Poor Responder Women. — Sfakianoudis K, Simopoulou M, Grigoriadis S et al. Journal of clinical medicine, 2020, case series, 128 citations · DOI: 10.3390/jcm9061809
  50. Preimplantation genetic testing for aneuploidy: A review of published blastocyst reanalysis concordance data — Diego Marín, Jia L. Xu, Nathan R. Treff Prenatal Diagnosis, 2020, systematic review, 77 citations · DOI: 10.1002/pd.5828
  51. Mesenchymal Stem Cells: A New Piece in the Puzzle of COVID-19 Treatment — Felipe Saldanha‐Araújo, Emañuella Melgaço Garcez, Amandda Évelin Silva-Carvalho et al. Frontiers in Immunology, 2020, expert opinion, 39 citations · DOI: 10.3389/fimmu.2020.01563
  52. Diagnostic efficiency of blastocyst culture medium in noninvasive preimplantation genetic testing — Jingbo Chen, Lei Jia, Tingting Li et al. F&S Reports, 2020, in vitro, 33 citations · DOI: 10.1016/j.xfre.2020.09.004
  53. Relationship between age and blastocyst chromosomal ploidy analyzed by noninvasive preimplantation genetic testing for aneuploidies (niPGT-A) — Laura Diniz Vagnini, Claudia Guilhermino Petersen, Adriana Renzi et al. JBRA, 2020, cohort, 9 citations · DOI: 10.5935/1518-0557.20200061
  54. Noninvasive preimplantation genetic testing for aneuploidies (niPGT-A) and the principle of primum non nocere — José Gonçalves Franco Jr, Felipe Dieamant, J.B.A. Oliveira JBRA, 2020, meta analysis, 5 citations · DOI: 10.5935/1518-0557.20200075
  55. Effects of Intraovarian Platelet Rich Plasma in Women With Poor Ovarian Response and Premature Ovarian Insufficiency Acibadem University, 2020, rct
  56. Ovarian Function Following Intraovarian Injection of PRP Center for Human Reproduction, 2020, rct
  57. Advanced Maternal Age in IVF: Still a Challenge? The Present and the Future of Its Treatment. — Ubaldi FM, Cimadomo D, Vaiarelli A et al. Frontiers in endocrinology, 2019, in vitro, 208 citations · DOI: 10.3389/fendo.2019.00094
  58. Autologous mitochondrial microinjection; a strategy to improve the oocyte quality and subsequent reproductive outcome during aging — Halimeh Mobarak, Mohammad Heidarpour, Pei‐Shiue Tsai et al. Cell & Bioscience, 2019, unknown, 62 citations · DOI: 10.1186/s13578-019-0360-5
  59. New Frontiers in IVF: mtDNA and autologous germline mitochondrial energy transfer — Mauro Cozzolino, Diego Marín, Giovanni Sisti Reproductive Biology and Endocrinology, 2019, expert opinion, 49 citations · DOI: 10.1186/s12958-019-0501-z
  60. Age-Related Hamster Mitochondrial Changes and Oocyte Changes Following Autologous Platelet Mitochondrial Microinjection — Fang Li ODU Digital Commons (Old Dominion University), 2019, animal · DOI: 10.25777/my8q-fg37
  61. Influence of Maternal Aging on Mitochondrial Heterogeneity, Inheritance, and Function in Oocytes and Preimplantation Embryos — Dori C. Woods, Konstantin Khrapko, Jonathan L. Tilly Genes, 2018, expert opinion, 56 citations · DOI: 10.3390/genes9050265
  62. Study of PRP in Women With Evidence of Diminished Ovarian Reserve Center for Human Reproduction, 2018, rct
  63. Stem cells, in vitro gametogenesis and male fertility — Go Nagamatsu, Katsuhiko Hayashi Reproduction, 2017, systematic review, 51 citations · DOI: 10.1530/rep-17-0510
  64. Improving oocyte quality by transfer of autologous mitochondria from fully grown oocytes — Stine Gry Kristensen, Susanne Elisabeth Pors, Claus Yding Andersen Human Reproduction, 2017, expert opinion, 48 citations · DOI: 10.1093/humrep/dex043
  65. In vitro gametogenesis: just another way to have a baby? — Sonia M. Suter Journal of Law and the Biosciences, 2015, expert opinion, 41 citations · DOI: 10.1093/jlb/lsv057
  66. Next generation sequencing for preimplantation genetic testing of blastocysts aneuploidies in women of different ages — Krzysztof Łukaszuk, Grzegorz Jakiel, Waldemar Kuczyński et al. Annals of Agricultural and Environmental Medicine, 2015, cohort, 17 citations · DOI: 10.5604/12321966.1196874
  67. Effects of oocyte bisphenol A exposure on aspects of oocyte maturation and early embryo development in Bos taurus — Jacqueline Ferris The Atrium (University of Guelph), 2015, animal
  68. Autologous Stem Cells Transplantation in Patients With Idiopathic and Drug Induced Premature Ovarian Failure El-Rayadh Fertility Centre, 2014, rct