Abstract
Background and Aims: Poor ovarian response (POR) is a pathological condition characterized by a reduced ovarian response to gonadotropin stimulation. This condition presents with a low number of developed follicles during the ovulation induction cycle, low blood estradiol (E2) peak, high gonadotropin dosage, fewer retrieved oocytes, increased cycle cancellation rate, and low clinical pregnancy rate. POR is a significant challenge in assisted reproductive technology. Autologous platelet-rich plasma (PRP) has emerged as a potential therapy for POR, but its efficacy remains controversial. This meta-analysis aims to determine the effect of intraovarian infusion of PRP on ovarian reserve and pregnancy outcomes in patients with POR. Methods: This study was designed as a Meta-analysis. Women diagnosed with POR based on POSEIDON or Bologna criteria were included. Primary outcomes included anti-Müllerian hormone (AMH), antral follicle count (AFC), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and E2 levels, while secondary outcomes were the number of retrieved oocytes and embryo quality. Results: Seven prospective cohort studies involving 202 participants were included. Intra-ovarian infusion of autologous PRP significantly increased AMH (SMD: 0.20, 95% CI: 0.05–0.36; P=0.01), AFC (SMD: 0.92, 95% CI: 0.59–1.25, P<0.05), and E2 (SMD: 3.46, 95% CI: 1.13–5.79; P=0.004) levels in patients with POR. PRP also decreased LH levels in POR (SMD: −1.17, 95% CI: −2.28 to −0.06; P=0.04). However, no statistically significant effect on FSH levels in POR was observed (SMD: −0.17, 95% CI: −0.78 to 0.44; P=0.59). Furthermore, PRP positively impacted the number of retrieved oocytes and embryo quality in IVF cycle patients. Conclusion: This meta-analysis indicates that intra-ovarian injection of autologous PRP can improve ovarian reserve and pregnancy outcomes in patients with POR.
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