Abstract

Advanced maternal age is associated with the natural oocyte depletion, leading to low oocyte yield, high infertility treatment cancellation rates, and eventual decreases in pregnancy rates. Various innovative interventions have been introduced to improve the outcome of infertility treatment for aging patients. Numerous published data demonstrated that early follicle development was regulated by intraovarian growth factors through autocrine or paracrine mechanisms. Platelet-rich plasma (PRP), a plasma fraction of peripheral blood with a high concentration of platelets, has been implemented in regenerative medicine in the last decade. The plasma contains a variety of growth factors that were suggested to be able to enhance angiogenesis regeneration and the cell proliferation process. The initial report showed that an intraovarian injection of PRP improved the hormonal profile and increased the number of retrieved oocytes in patients with diminished ovarian reserve. Subsequently, several studies with larger sample sizes have reported that this approach resulted in several healthy live births with no apparent complications. However, the use of ovarian PRP treatment needs to be fully investigated, because no randomized controlled trial has yet been performed to confirm its efficacy.

Highlights

  • Along with the global modernization, women tend to delay their childbearing due to professional investment and seeking better living conditions

  • We comprehensively summarized the hypothesis and reported clinical results involving the autologous Platelet-rich plasma (PRP) intraovarian injections to “rejuvenate” ovaries

  • In the first study describing the benefit of PRP on ovarian function, a patient without ovaries obtained a healthy baby in the first cycle of stimulation after ovarian tissue grafting

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Summary

Introduction

Along with the global modernization, women tend to delay their childbearing due to professional investment and seeking better living conditions. Recent data revealed a significant rise in the mean age of first-time mothers, ranging between the third and fourth decade [1,2] This is associated with ovarian aging, which is a physiological process characterized by declining oocyte quantity and quality—an unsolved problem in reproductive medicine. Premature ovarian insufficiency (POI), a condition characterized by a premature decline of ovarian function occurring before the age of 40, has risen from 1% to nearly 2% in the last few decades [3,4] These changes placed a requirement of implementation therapeutic strategies for these low prognostic infertile women. Several subsequent reports revealed that that intraovarian injection of PRP promoted the follicle growth and improved the treatment outcome in poor prognostic infertile women, resulting in several live births without complications. We comprehensively summarized the hypothesis and reported clinical results involving the autologous PRP intraovarian injections to “rejuvenate” ovaries

Bioactive Factors in PRP and their Role in Folliculogenesis
Case Report and Case Series Studies
Comparative Studies
Findings
Conclusions
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