Effect of intra ovarian injection of platelet rich plasma to patients with diminished ovarian reserve (DOR)- A Prospective Study

Abstract

Background: Diminished ovarian reserve (DOR) is among the common findings in infertile women with no significant underlying condition especially women with advanced age. The aim of this study was to investigate the intra-ovarian potential of platelet-rich plasma (PRP) administration on oocytesdependent variables in the DOR women. A few years ago, we used intrauterine PRP injection in patients with recurrent implantation failure (RIF) which led to noticeable findings. Nowadays, PRP is used more widely in reproductive medicine due to its regenerative potentials; however, not enough data is available on this issue. One of the new strategies for facing primary ovarian insufficiency is PRP therapy. Material and Methods: This is a Prospective cohort study conducted in three IVF Clinics Thane-India, Almaty-Kazakhstan and Tashkent- Uzbekistan from October 2021 to September 2022. All couples with failed IVF with diminished ovarian reserve as per ARSM definition between the age group of 35 to 45 (both inclusive). To standardize the definition of poor ovarian response, a European Society of Human Reproduction and Embryology Working Group convened in Bologna and proposed that two of the following criteria be present to define whether a given low response to stimulation is truly representative of poor ovarian response: 1) Advanced maternal age (R40 years). 2) A previous poor ovarian response. Result: Demographic characteristics, baseline ovarian reserve markers and ultrasound findings of women included in the analysis Table 1. Women treated with PRP had significant improvement in biochemical and ultrasound markers of ovarian reserve. Notably, AMH levels were on average 72% higher following PRP (P < 0.001). Of the 124 women who underwent IVF/ICSI following participation in the study, those with previous PRP treatment yielded an average more than 1.5× the number of oocytes collected. Conclusion: This study revealed that the injection of PRP into human ovaries is safe and improves ovarian reserve markers as measured by antral follicle count and serum levels of AMH and FSH. Nevertheless, further studies are needed to evaluate the impact of PRP on pregnancy outcomes in women undergoing ART.