Original Articles

The Role of Platelet-Rich Plasma (PRP) in Enhancing IVF Success in Women With Ovarian Insufficiency: A Cohort Study

Abstract

Ovarian insufficiency is a significant cause of infertility in women, with limited effective treatment options. Platelet-Rich Plasma (PRP), rich in concentrated growth factors, has shown regenerative potential in various medical fields. However, its efficacy as an adjunct in infertility treatment, particularly in women with ovarian insufficiency, remains unclear. This study investigates whether PRP administration improves the success of IVF cycles in this specific population. This cohort study followed women with ovarian insufficiency undergoing IVF at a fertility center. Participants were divided into two groups: the intervention group, which received PRP alongside the standard IVF protocol, and the control group, which received only the standard protocol. Data collected included patient demographics, hormonal levels, number and quality of retrieved oocytes, fertilization rates, embryo quality, and pregnancy outcomes. The primary outcome was IVF success, defined by clinical pregnancy rates. Secondary outcomes included hormonal changes, oocyte quality, and embryo development. Statistical analysis utilized descriptive statistics, chi-square tests, and t-tests to compare outcomes between groups. PRP administration led to significant reductions in FSH levels (P<0.001) and marked increases in AMH levels and antral follicle count (AFC) (P=0.001 and P<0.001, respectively). The number of oocytes, mature MII oocytes, and Grade A embryos also improved significantly (P ranging from 0.004 to 0.017). Although the increase in Grade B embryos was not statistically significant, it was higher post-PRP. Chemical pregnancies occurred in 25% of participants, with 20.83% resulting in clinical pregnancies, including 2.1% spontaneous pregnancies. PRP significantly enhanced ovarian reserve markers (FSH, AMH, AFC), oocyte quality, and embryo development, translating into improved fertility outcomes. The findings suggest that with longer follow-up and larger sample sizes, PRP could be validated as a promising adjunctive therapy for women with ovarian insufficiency undergoing IVF. These results align with prior research and highlight PRP’s potential to advance reproductive outcomes in this challenging patient population.

 

1. AM Everts P, M Hoogbergen M, A Weber T, JJ Devilee R, van Monftort G, HJT de Hingh I. Is the use of autologous platelet-rich plasma gels in gynecologic, cardiac, and general, reconstructive surgery beneficial? Curr Pharm Biotechnol 2012;13:1163-72.
2. Lai LP, Stitik TP, Foye PM, Georgy JS, Patibanda V, Chen B. Use of platelet-rich plasma in intra-articular knee injections for osteoarthritis: a systematic review. PM R 2015;7:637-48.
3. Dhillon RS, Schwarz EM, Maloney MD. Platelet-rich plasma therapy-future or trend? Arthritis Res Ther 2012;14:219.
4. Wang SZ, Chang Q, Lu J, Wang C. Growth factors and platelet-rich plasma: promising biological strategies for early intervertebral disc degeneration. Int Orthop 2015;39:927-34.
5. Dawood AS, Salem HA. Current clinical applications of platelet-rich plasma in various gynecological disorders: An appraisal of theory and practice. Clin Exp Reprod Med 2018;45:67-74.
6. Varghese J, Acharya N. Platelet-Rich Plasma: A Promising Regenerative Therapy in Gynecological Disorders. Cureus 2022;14:e28998.
7. Kim H, Shin JE, Koo HS, Kwon H, Choi DH, Kim JH. Effect of Autologous Platelet-Rich Plasma Treatment on Refractory Thin Endometrium During the Frozen Embryo Transfer Cycle: A Pilot Study. Front Endocrinol (Lausanne) 2019;10:61.
8. Ferraretti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L; ESHRE working group on Poor Ovarian Response Definition. ESHRE consensus on the definition of 'poor response' to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod 2011;26:1616-24.
9. Seckin S, Ramadan H, Mouanness M, Kohansieh M, Merhi Z. Ovarian response to intraovarian platelet-rich plasma (PRP) administration: hypotheses and potential mechanisms of action. J Assist Reprod Genet 2022;39:37-61.
10. Panda SR, Sachan S, Hota S. A Systematic Review Evaluating the Efficacy of Intra-Ovarian Infusion of Autologous Platelet-Rich Plasma in Patients With Poor Ovarian Reserve or Ovarian Insufficiency. Cureus 2020;12:e12037.
11. Éliás M, Kónya M, Kekk Z, Turan C, das Virgens IPA, Tóth R, et al. Platelet-rich plasma (PRP) treatment of the ovaries significantly improves fertility parameters and reproductive outcomes in diminished ovarian reserve patients: a systematic review and meta-analysis. J Ovarian Res 2024;17:104.
12. Fraidakis M, Giannakakis G, Anifantaki A, Skouradaki M, Tsakoumi P, Bitzopoulou P, et al. Intraovarian Platelet-Rich Plasma Injections: Safety and Thoughts on Efficacy Based on a Single Centre Experience With 469 Women. Cureus 2023;15:e38674.
13. Sfakianoudis K, Simopoulou M, Grigoriadis S, Pantou A, Tsioulou P, Maziotis E, et al. Reactivating ovarian function through autologous platelet-richplasma intraovarian infusion: pilot data on premature ovarian insufficiency, perimenopausal, menopausal, and poor responder women. J Clin Med 2020;9:1809.
14. Theodore S, Strong Z, Broussard A, Luk J, Hade JJ, Mortimer K, et al. OVARIAN PLATELET-RICH PLASMA TREATMENTS MAY REINSTATE OVULATION IN PERIMENOPAUSAL WOMEN AND SIGNIFICANTLY DECREASES SERUM FSH. Fertil Steril 2022;118:e164.
15. Li X, Liu H, Lin G, Xu L. The effect of ovarian injection of autologous platelet rich plasma in patients with poor ovarian responder: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023;14:1292168.
16. Davari Tanha F, Salimi Setudeh S, Ebrahimi M, Feizabad E, Khalaj Sereshki Z, Akbari Asbagh F, et al. Effect of intra-ovarian platelet rich plasma in women with poor ovarian response. Caspian J Intern Med 2023;14:485-9.
17. Cakiroglu Y, Yuceturk A, Karaosmanoglu O, Kopuk SY, Korun ZEU, Herlihy N, et al. Ovarian reserve parameters and IVF outcomes in 510 women with poor ovarian response (POR) treated with intraovarian injection of autologous platelet rich plasma (PRP). Aging (Albany NY) 2022;14:2513-23.
18. Hosseinisadat R, Farsi Nejad A, Mohammadi F. Intra-ovarian infusion of autologous platelet-rich plasma in women with poor ovarian reserve: A before and after study. Eur J Obstet Gynecol Reprod Biol 2023:280:60-3.
19. Molinaro P, Pellicer A, Requena A, Herraiz S, Garcia-Velasco JA, Munoz M, et al. AUTOLOGOUS PLATELET RICH PLASMA (PRP) INTRAOVARIAN INJECTION TO IMPROVE OVARIAN RESERVE PARAMETERS AND REPRODUCTIVE POTENTIAL IN POOR OVARIAN RESPONDER (POR) WOMEN UNDER 40 YEARS OLD. Fertil Steril 2023;120:e138.
20. Shrivastava J, More A, Shrivastava V, Choudhary N, Shrivastava D. Enhancement of Ovarian Reserve and Oocyte Quality After Platelet-Rich Plasma Instillation in a Woman With Diminished Anti-Müllerian Hormone. Cureus 2024;16:e53474.
21. Parvanov D, Ganeva R, Vidolova N, Nikolova K, Vasileva M, Totev T, et al. Autologous ovarian platelet rich plasma treatment improves oocyte and embryo quality: a before-after prospective study. Biotechnol Biotechnological Equipment 2022;36:425-32.
22. Farimani M, Nazari A, Mohammadi S, Anvari Aliabad R. Evaluation of intra-ovarian platelet-rich plasma administration on oocytes-dependent variables in patients with poor ovarian response: A retrospective study according to the POSEIDON criteria. Reprod Biol Endocrinol 2021;19:137.
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IssueVol 62 No 5 (2024) QRcode
SectionOriginal Articles
DOI https://doi.org/10.18502/acta.v62i5.17774
Keywords
Infertility Ovarian insufficiency Platelet-rich plasma (PRP) In vitro fertilization (IVF) Oocyte quality Embryo quality Clinical pregnancy

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How to Cite
1.
Mohammad Alipour Z, Ahmadi F, Mohajernoei S, Gharaei R, Hojjati N, Shirali E, Akbari Asbagh F. The Role of Platelet-Rich Plasma (PRP) in Enhancing IVF Success in Women With Ovarian Insufficiency: A Cohort Study. Acta Med Iran. 2025;62(5):264-272.