SEGO/VA approach has several steps. Laparoscopy with partial ovarian decortication is the first step. After the fragmentation of gonadal tissue, the incubation in autologous PLRP for 48h is performed. The orthotopic re-transplantation is performed after 3d colour Doppler vascular ovarian mapping, with ultrasound guidance.
1. Laparoscopy with ovarian partial decortication
2. Blood sampling for PLRP growth factors
3. Gonadal tissue fragmentation
4. Gonadal tissue incubation with PLRP growth factors
5. Ultrasonic guided orthotopic gonadal tissue re-transplantation
The SEGO/VA approach has several essential advantages over Kawamura’s approach. First, conservative surgery with partial decortication instead of ovariectomy is performed, allowing orthotopic instead of heterotopic approach during re-transplantation. Besides that, instead of chemical stimulation of Akt pathway, autologous PLRP growth factors are used. The second laparoscopic operation is avoided, using needle injection under colour Doppler ultrasonic guidance.
Possible complications are related to the laparoscopy and injection of blood and tissue elements into the ovary. The complication rate is less than 5% and can involve infection, bleeding, punctures or injuries to the surrounding organs and complication with anesthesia. Serious complications requiring hospital treatment are significantly less frequent.
First results are to be expected in a few months and full effects are expected within 6 months. In the period following the treatment, if sterility is the case, standard in vitro fertility treatments are performed in a natural, modified and stimulated cycle. We track all changes in hormonal, immunological and reproductive parameters and closely follow and assess the results of the treatment.