Publication:

Intraovarian platelet-rich plasma injection: a potential path to genetic parenthood for women with low ovarian reserve

Background The incidence of women with low ovarian reserve (LOR) presenting for ART is increasing. Infertility management is challenging since oocyte numbers are related to IVF success. The use of intraovarian platelet rich plasma (IOPRP) is emerging as a promising technique for ovarian rejuvenation. This study evaluates role of IOPRP in improving ovarian reserve markers, ovarian response and reproductive outcomes in women with LOR keen to achieve genetic parenthood.

Methods This prospective observational cohort study was done on 85 women of Indian ethnicity 25-50 years, Poseidon group 3 and 4, infertility >3 years wih at least 1 previous IVF failure. One ml of PRP prepared by double centrifugation technique was injected into each ovary transvaginally. AMH, AFC, FSH, ovarian response measured pre and post IOPRP.

Results At 8 weeks post PRP a statistically significant increase in AMH (0.57±0.33 ng/ml vs 0.96±0.49 ng/ml p<0.001), AFC (4.11±1.81 vs 7.81±3.35 p<0.001), number of oocytes retrieved (3.29±2.22 vs 5.52±3.66 p<0.001) and number of usable embryos (1.11±1.21 vs 2.33±2.12, p<0.001) was seen. Of women who underwent IVF 57.1% achieved clinical pregnancy. Overall Live birth rate was 38.09%, 8 women conceived without IVF with a live birth rate of 40%.  Poseidon group 3 showed a greater improvement.

Conclusions The study suggests that IOPRP treatment increases ovarian reserve markers and response and may be a viable alternative to donor oocytes in women with LOR wanting genetic parenthood.