Poor responders are described as those In Vitro Fertilization (IVF) patients who are failing to respond to controlled ovarian stimulation protocols. Extensive research has focused on crafting the optimal treatment. However, it appears that each approach fails to be established as effective or guaranteed towards successful management. Platelet-Rich Plasma (PRP) is a novel, highly promising approach that has been successfully applied for an array of medical issues. In this case series, we present 3 poor responder patients with the common denominator of: failed IVF attempts, poor oocyte yield, and poor embryo quality. The option of oocyte donation was rejected. All patients were treated with autologous PRP ovarian infusion following written consent. Within a 3-month interval, follicle-stimulating hormone decreased by 67.33%, while Anti-Müllerian hormone increased by 75.18%. These impressive results on the biochemical infertility markers alone are classified as a complete biological paradox, coupled by improved embryo quality. Results report a natural conception at 24 weeks, an uncomplicated healthy pregnancy at 17 weeks and a successful live birth. To our knowledge, this is the first time such an approach and results are reported, where PRP treatment on poor responders lead to overcoming their challenging reproductive barrier.
Premature ovarian insufficiency (POI) severely limits reproductive options. We report a successful live birth in a patient with POI following a combined approach of intraovarian platelet-rich plasma (PRP) treatment, double ovarian stimulation (DuoStim protocol), and preimplantation genetic testing for aneuploidy (PGT-A). PRP treatment was performed to restore ovarian function, after which DuoStim was used to maximize oocyte yield. An embryo obtained underwent PGT-A, and transfer of a euploid blastocyst resulted in an uncomplicated pregnancy and the birth of a healthy child. This case highlights the potential of personalized and multidisciplinary strategies to overcome the traditional barriers in POI by integrating regenerative medicine (PRP), advanced ovarian stimulation (DuoStim), and genetic embryo selection (PGT-A). While this innovative approach appears promising for women with diminished ovarian reserve, further studies are needed to confirm its efficacy and safety.
Sanuie Farimani M et al., 2025·International journal of reproductive biomedicine
Female infertility, especially in those individuals with poor ovarian response (POR), is a challenge in the field of infertility and sterility. Recently, intra-ovarian platelet-rich plasma (IO-PRP) administration has been suggested as a possible co-treatment. This study aimed to investigate the biodemographic characteristics of individuals who experienced spontaneous pregnancy following IO-PRP. In this cross-sectional study, out of 1548 women diagnosed with POR who underwent IO-PRP, 596 individuals who completed their 2-yr follow-up period, were included. Different types of demographic and pre-intervention laboratory data (blood levels of anti-Müllerian hormone, luteinizing hormone, follicle-stimulating hormone, estradiol, prolactin, and their spouses' sperm analysis results) were collected from the files. Each individual was classified into a certain group according to the POSEIDON criteria, and their data were compared. The results showed that 50 (8.39%) spontaneous pregnancies were observed. However, 8 were excluded from further analyses due to missing data in their critical variables. The most prevalent POSEIDON group was 4, with a prevalence of 17/42 (40.47%). Among the POSEIDON groups, covariates including the age of the individuals and their spouses, body mass index, anti-Müllerian hormone, and antral follicle/oocytes count following the latest IO-PRP significantly differed (p < 0.001, p < 0.001, p = 0.039, p < 0.001, and p = 0.022, respectively). The spontaneous pregnancy rate following IO-PRP among women with POR was low. However, significant differences in biodemographic and hormonal characteristics were observed between the groups with and without spontaneous pregnancy which could be useful in leading future studies on this subject.
restorative-reproductive-medicine/adjunct-and-emerging-therapies/platelet-rich-plasma-and-regenerative-approachesreproductive-endocrinology/ovarian-hormones/estrogeninfertility/ovulation-induction/gonadotropin-therapy
Open Access
Ovarian rejuvenation is an innovative procedure intended to restore ovarian fertility and development during the climacteric and has been used to enhance fertility in women with premature ovarian insufficiency (POI). This retrospective study was conducted to determine the effects of an intraovarian platelet-rich plasma (PRP) injection on ovarian stimulation outcomes in women referred to an in vitro fertilisation centre. Methods- Population: This was a retrospective observational study, and the inclusion criteria included women of reproductive age with at least one ovary with a history of infertility, hormonal abnormalities, an absence of a menstrual cycle, and premature ovarian failure. During the patient's first consultation, a detailed reproductive history was recorded, a pelvic scan for ovarian size was conducted, and hormonal analysis for follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), estradiol (E2), and luteinizing hormone (LH) was conducted. In the study, 469 women with a history of infertility, hormonal abnormalities, an absence of a menstrual cycle, and premature ovarian failure had hormonal levels recorded up to four months after treatment, and these were included in the study. The volume of peripheral blood required to prepare 6-8 mL of PRP for administration was 40-60 mL. The initial concentration of platelets in the peripheral blood sample was about 25000/µL, whereas the prepared PRP had a concentration of 900.000/µL. A volume of approximately 2-4 mL per ovary, depending on the ovarian volume, was used for the intraovarian injection. PRP intervention had significant effects on FSH concentration at the α = 0.05 level. Statistically significant increases in normal values of FSH and E2were observed for months three and four after the PRP intervention for all age groups. The results of our observational study revealed that a PRP intraovarian injection is associated with improved ovarian tissue and function. Future randomised clinical trials are needed to shed light on the use of PRP in ovarian rejuvenation before offering it routinely in clinical practice.
Sabouni R et al., 2022·Annals of medicine and surgery (2012)
The prevalence of Primary ovarian insufficiency (POI) is estimated to be 1-2%, resulting from many causes, including, iatrogenic causes which are becoming more common.There is no precise treatment to restore fertility in POI patients. However, new treatments -such as ovarian rejuvenation using platelet-rich autologous plasma (PRP)- are being tested and have shown promising results. We report using a new PRP injection protocol to manage a Syrian patient with ovarian insufficiency. A 35-year-old woman with five years of primary infertility presented with decreased anti-mullerian hormone (AMH) after she underwent a laparoscopy one year ago. Where the AMH dropped from 1.07 to 0.39 ng/mL after it. She underwent an ovarian rejuvenation using PRP. Half mL of PRP was injected into every ovary, 2 mL were injected into the cervix, 7 mL intra-uterus, and 7 mL were injected intramuscularly to the patient's legs. Fifteen days following the operation, the patient's new AMH level was 0.94 ng/mL. The patient was placed on ovarian stimulation, and five days later the ultrasonography showed the development of six follicles in each ovary. Managing POI using ovarian rejuvenation is the best alternative treatment; When the donor eggs programs are not acceptable. The use of PRP in ovarian rejuvenation has been reported to be effective. The use of PRP was beneficial in restoring fertility in a Syrian patient with ovarian insufficiency. Furthermore, the new PRP injection protocol was successful. However, more studies are needed to confirm this result.