Intraovarian Injection of Lyophilized Platelet-Rich Plasma in Patients with Poor Ovarian Response

Abstract

Objective: To demonstrate the effect of intraovarian injection of lyophilized platelet-rich plasma (PRP) in poor ovarian responders. Methods: This retrospective cohort study evaluated data for 262 women who underwent intraovarian injection of lyophilized PRP at two private fertility clinics. Women treated from December 2021 to September 2022 and who met the Bologna criteria were included. Intraovarian injection of lyophilized PRP prepared from 50[Formula: see text]mL of autologous peripheral blood was followed by two centrifugations and activation with 2% CaCl2, in which cells were removed with a filter and stored at room temperature. The differences in the follicle-stimulating hormone and antral follicle count (AFC), and the number of retrieved oocytes, mature oocytes, fertilized embryos, cleavage embryos, and blastocysts were measured before and 3 months after a single injection. A biological pregnancy with embryos generated after injection was also examined. Results: Patients’ median age and anti-Mullerian hormone (AMH) levels were 44 years and 0.38[Formula: see text]ng/mL, respectively. The number of retrieved oocytes or mature oocytes and fertilized embryos or cleavage embryos was higher after injection. The number of cleavage embryos in women [Formula: see text] years significantly increased after injection. Of the 262 patients who underwent intraovarian injection of lyophilized PRP, 71 underwent embryo transfers using embryos obtained 3 months after injection, and 14 had biological pregnancies. Seven of these patients were in their 40s. Out of 14, one had a live birth, six are ongoing pregnancies, six had chemical abortions, and one had a miscarriage. Conclusions: Intraovarian injection of lyophilized PRP improved egg retrieval results, especially in patients older than 40 years. Furthermore, this treatment may contribute to biological pregnancy in patient with poor ovarian response but needs to be further investigated in more cases in the future.