2025
Premature Ovarian Insufficiency: Hope for 'Failing' Ovaries
Author affiliations
- UPMC Divine Mercy Women's Health
2025
Whittaker, N. M. (2025). Premature Ovarian Insufficiency: Hope for 'Failing' Ovaries.
Whittaker NM. Premature Ovarian Insufficiency: Hope for 'Failing' Ovaries. 2025.
Costanzi F et al., 2025 · Cureus
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.
Fraidakis M et al., 2023 · Cureus
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.
Check JH et al., 2022 · Gynecol Reprod Health
Many infertility specialists advise women with diminished oocyte reserve (DOR) that their remaining oocytes probably are of poor quality similar to women of advanced reproductive age. There have been studies, especially employing in vitro fertilization-embryo transfer (IVF-ET), showing very poor live delivered pregnancy rates despite the transfer of morphologically normal embryos in women even with mild DOR. However, other data suggests that the low pregnancy rates are related to the use of high dosages of follicle stimulating hormone (FSH) drugs which down-regulate some key FSH dependent enzymes, cytokines, or proteins required for proper embryo implantation. Some studies have shown that techniques that favor FSH receptor up-regulation, rather than down-regulation, can provide the chance of live delivery 80% as well in women ≤ 35 with DOR, 70% for women 36-39, and 50% for women 40-42. Though some infertility specialists will encourage women whose only infertility issue is DOR, who reject the initial suggestion to consider donor oocytes, to proceed immediately with IVF-ET to maximize success, pregnancies are quite possible with natural conception. Thus, it seems imprudent to make couples undergo the financial burden of IVF-ET in the absence of a significant tubal or male factor problem. Not only have live deliveries occurred in women with DOR, using the principle described to achieve a mature dominant follicle followed by proper luteal phase support, with serum FSH levels over 100 mIU/mL, but also serum Anti-Mullerian Hormone (AMH) levels that were undetectable. This even applies to women in overt menopause where FSH up-regulation was achieved by negative feedback to the pituitary using ethinyl estradiol inhibiting FSH release, or down-regulation of hypothalamic-pituitary stimulation of FSH production by using gonadotropin releasing hormone agonists or antagonists.