#98 : Autologous Platelet-Rich Plasma Administration’s Efficacy in Patients with Low Ovarian Reserve: A Systematic Review and Meta-Analysis

Abstract

Background and Aims: Autologous platelet-rich plasma (PRP) as a novel therapeutic approach has been utilized in multiple aspects of medicine because it contains stem cells and growth factors. There is still controversy over the effectiveness of this strategy in managing infertile women with low ovarian reserve due to the lack of evidence-based studies. This study aimed to systematically investigate and meta-analyze the best available evidence from clinical trials evaluating the impact of autologous platelet-rich plasma on low ovarian reserve. Methods: Systematic searches in electronic databases including PubMed, Cochrane, and Google Scholar use relevant search terms. We included infertile women with low ovarian reserve in single-arm clinical trials. Ovarian reserve parameters were measured before and after PRP injection into the ovaries. Data were extracted from each eligible study, then pooled (meta-analysis). The risk of bias (RoB) was evaluated using RoB 2 assessment tools. Results: Three hundred and one articles were collected and excluded, leaving six eligible studies, then classified into two subgroups: poor ovarian response (POR) and primary ovarian insufficiency (POI). Following PRP injection, infertile women showed an improvement in ovarian reserve. There was a significant increase in anti-Mullerian hormone (AMH) level (MD = 0.12, 95% CI [0.005; 0.23], I2=99%, subgroup differences p=0.33), a significant increase in antral follicle count (AFC) (MD = 1.88, 95% CI [0.86; 2.89], I2=93%, subgroup differences p=0.67), with a non-significant reduction in follicle-stimulating hormone (FSH) level (MD = 0.32, 95% CI [0.18; 0.46], I2=94%, subgroup differences p=0.02). According to the RoB’s assessment, the original research studies’ overall quality was a low risk of bias. Conclusions: Autologous platelet-rich plasma may increase AMH and AFC, but not FSH. Although it was discovered beneficial in enhancing ovarian reserve and effective for ovarian rejuvenation, further research with a large number of samples and strong evidence is still required.