Effect of Intraovarian Platelet-Rich Plasma Injection on Ovarian Function and Reproductive Outcomes in Patients with Poor Ovarian Response.

BACKGROUND: Platelet-rich plasma (PRP), derived from peripheral blood, contains bioactive mediators that support cellular repair and tissue regeneration. PRP is thought to play a key role in the repair of ovarian tissue post-ovulation and may positively impact ovarian reserve. This study aims to investigate the potential of platelets and their derivatives in enhancing ovarian function in patients with poor ovarian response (POR) to ovulation stimulation. METHODS: This randomized controlled trial was conducted on infertile patients with POR undergoing intracytoplasmic sperm injection (ICSI) and frozen embryo transfer (FET) cycles. Eligible patients were randomly assigned to either the control group (n = 29) or the intervention group (n = 29), with the intervention group receiving bilateral intraovarian PRP injections during their first ovum pick-up. PRP efficacy was evaluated by comparing hormone levels, the number of retrieved oocytes and embryos in the subsequent ovum pick-up after PRP treatment, as well as pregnancy outcomes between the two groups. RESULTS: Data showed that the PRP-treated group had significantly higher levels of anti-Müllerian hormone (AMH) and estradiol, along with a greater number of retrieved oocytes, mature (MII) oocytes, embryos, and high- quality embryos compared to controls (P < 0.05). Biochemical pregnancy, clinical pregnancy, and live birth rates were also markedly higher in the PRP group (P < 0.05), while miscarriage rate did not differ significantly between groups (P > 0.05). CONCLUSION: These findings suggest that intraovarian PRP injections may enhance ovarian response and improve reproductive outcomes in patients with POR. However, it recommends further research to confirm PRP's effectiveness before considering it as a standard adjuvant therapy for POR.