Novel Approach for Poor Ovarian Reserve with Autologous Platelet Rich Plasma (PRP) Therapy

The present study was conducted to observe the effectiveness of platelet rich plasma infusion through measurement of AMH and AFC values and pregnancy outcomes. Though ovarian aging is a normal process but the term Poor ovarian reserve (POR) implies when the quality and quantity of the follicular pool decreases in women with reproductive age groups. Sometimes the condition becomes an obstacle for pregnancy and compromising fertility. It may be seen in advanced years of reproductive life or without any reason or may occur in young women with different etiological factors. Women with poor ovarian reserve should be evaluated properly and individualising their therapeutic strategies for optimizing the success rate. Majority of women with POR need to undergo in vitro fertilization to achieve pregnancy. Sometimes ovum donation and embryo donation are not acceptable to some couples for psych-social reason or religious reason. To improve the situation many treatment approaches have been studied. Among them one of the novel approaches is Autologous platelet rich plasma therapy.

This prospective observational study was done in the department of reproductive endocrinology and infertility from July 2019 to June 2022. A total of 60 patients with poor ovarian reserve were recruited maintaining inclusion and exclusion criteria.

At first cycle, compared to baseline counts, mean±SD AMH had increased by 0.04±0.15 ng/dl, and mean±SD AFC had increased by 1.34±1.89 in number. During second cycle post-PRP, the mean difference of AMH and AFC was 0.18±0.21 ng/dl and 2.17±1.71 in a positive manner. By final follow-up, pregnancy rate was 20% among patients. Ovarian PRP infusion had a pregnancy success rate of 23.33%, which was similar to other previous studies with similar short follow-up history. 18,21-23 PRP had been proven to be an effective method for ovarian rejuvenation in terms of AMH and AFC in the present study.

Following PRP infusion, the study saw a considerable improvement in AMH and AFC values. Both results gradually improved; an increase in AMH values was seen up to the second post-PRP menstrual cycle, while an increase in AFC was shown up to the third cycle post-PRP. Twelve (12) of the 60 patients (20%) were pregnant. PRP ovarian treatment resulted in improved oocyte and embryo quality in approximately three-fourths of patients and application of this therapy would therefore likely increase the success rate of IVF cycles in poor responders.