Abstract
While the advanced reproductive technologies have attained remarkable increases in sophistication, success, and availability since the 1980’s, a therapeutic impasse continues to be reached when ovarian reserve reaches exhaustion. Irrespective of fertility aspirations, the deterioration and eventual collapse of ovarian estrogen output means that menopause arrives with tremendous physiologic change and reduced overall productivity. Because more women are gaining in longevity or delaying age at pregnancy, the number of affected patients has never been larger. As concerns with standard hormone replacement therapy and limitations of IVF are confronted, a workable path to enable primordial germ cell recruitment and _de novo_ oocyte development would be welcome. Proof-of-concept case reports and clinical studies on autologous activated platelet-rich plasma (PRP) or its condensed cytokine derivatives suggest a way to facilitate these goals. But ovarian PRP faces vexing challenges which place ‘ovarian rejuvenation’ under caution as it enters this therapeutic space. Here we review key features of experimental human ovarian stem cell isolation/handling and reaffirm the need to harmonize laboratory protocols. Recognizing the regenerative science borrowed from other disciplines, specimen centrifugation, platelet processing, and condensed plasma cytokine enrichment are highlighted here. Because refinement of this rejuvenation approach would promise to reprogram adult ovarian physiology, disruption of established treatment paradigms for infertility, menopause, and perhaps overall women’s health seems likely. Emerging roles in reproductive biology and clinical practice are thus placed in a broader social and demographic context.