Merhi, Z., Garg, B., & Haroun, J. (2025). First live births after adipose-derived stem cells and platelet-rich plasma intraovarian administration. American journal of stem cells, 14(5), 277-283. https://doi.org/10.62347/KWFR2442
Merhi Z, Garg B, Haroun J. First live births after adipose-derived stem cells and platelet-rich plasma intraovarian administration. American journal of stem cells. 2025;14(5):277-283. doi:10.62347/KWFR2442
Merhi, Zaher, et al. "First live births after adipose-derived stem cells and platelet-rich plasma intraovarian administration." American journal of stem cells, vol. 14, no. 5, 2025, pp. 277-283.
Two women 45 and older gave birth after ovarian PRP and fat injections
Among two women aged 45 and older in a case report, each delivered a healthy infant after ovarian injections of processed fat (nanofat) and platelet-rich plasma (PRP). One woman conceived naturally six months after the procedure. The other conceived through frozen embryo transfer. Both had earlier IVF cycles that produced no pregnancy.
Key Findings
Case 1, a 46-year-old woman with diminished ovarian reserve and a prior miscarriage, conceived naturally six months after the procedure and delivered a healthy infant vaginally at age 47.
Her antral follicle count, an ultrasound count of small ovarian follicles, increased from a baseline of 2 to 14 by six months after the procedure.
Case 2, a 45-year-old woman with endometriosis, produced four mature oocytes and 2 blastocysts, 1 euploid and 1 aneuploid, in an IVF cycle three months after the procedure.
Frozen embryo transfer of the euploid embryo led to a pregnancy without complications and a healthy infant delivered by cesarean section. The second woman conceived within nine months of the procedure.
Before the combined procedure, both women had received intraovarian PRP injections followed by minimal stimulation IVF, which yielded no oocytes in Case 1 and no euploid embryo in Case 2.
Interpretation
The study is a case report of two women, with no control group and follow-up limited to the pregnancies described. The authors state that causality cannot be established. They note that the first woman's spontaneous pregnancy, although rare at that age, cannot be excluded as occurring without the procedure. The second woman's pregnancy came from the transfer of an embryo created in an IVF cycle. Ovarian reserve markers and follicular dynamics were not serially measured at short intervals. Both women had earlier received intraovarian PRP injections.
RRM Context
Restorative reproductive medicine looks for why a couple's fertility is reduced and treats that cause, with cycle tracking in the evaluation. The first woman timed intercourse each month with ovulation predictor kits and conceived naturally. The second woman had endometriosis, and the report describes no treatment of it. The report describes no evaluation of either partner. IVF bypasses the reason conception has not occurred.
Our editorial summary of this paper, not the article's abstract.
Abstract
This report describes two women aged 45 and older who achieved live births following intraovarian administration of a novel combination of mechanically processed adipose nanofat rich in adipose-derived stem cells (ADSCs) and autologous platelet-rich plasma (PRP). Both patients had a history of prolonged infertility and multiple failed assisted reproductive technology cycles with in vitro fertilization (IVF). Case 1, a 46-year-old with diminished ovarian reserve and prior miscarriage, underwent adipose-PRP treatment after unsuccessful minimal stimulation IVF. Six months later, she conceived naturally and delivered a healthy infant at age 47. Case 2, a 45-year-old with endometriosis and multiple failed IVF attempts, conceived via frozen embryo transfer of her only euploid embryo produced three months after adipose-PRP treatment, resulting in the birth of a healthy infant. The combination approach was developed to comply with U.S. FDA minimal manipulation guidelines, avoiding enzymatic processing of adipose tissue. This report is, to our knowledge, the first to document natural conception in women with age over 45 following combined adipose nanofat ADSCs and PRP intraovarian injection, and among the few to describe live births at this age using autologous oocytes after such therapy. These findings suggest that adipose-PRP treatment may offer a promising regenerative option for women with extremely diminished ovarian reserve who desire genetically related offspring, though controlled studies are required to confirm long term safety, efficacy, and appropriate patient selection.
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