Top

BMC Pregnancy and Childbirth

Published in:

Open Access 01-12-2024 | Research

The value of intraovarian autologous platelet rich plasma in women with poor ovarian reserve or ovarian insufficiency: a systematic review and meta-analysis

Authors: Ahmed M. Maged, Reham A. Mohsen, Noha Salah, Wael S. Ragab

Published in: BMC Pregnancy and Childbirth | Issue 1/2024

Abstract

Objectives

To assess the value of intraovarian PRP in women with low ovarian reserve.

Search strategy

Screening of databases from inception to January 2023 using the keywords related to “Platelet-rich plasma” AND “poor ovarian reserve” OR “ovarian failure”.

Selection criteria

Fourteen studies (1632 participants) were included, 10 included women with POR, 1 included women with POI and 3 included both POR and POI women.

Data collection and analysis

Extracted data included study settings, design, sample size, population characteristics, volume, timing and preparation of PRP administration, and outcome parameters.

Main results

AMH level was evaluated in 11 studies (2099 women). The mean difference (MD) was 0.09 with 95% CI of – 0.06, 0.24 (P = 0.25). Antral follicular count level was assessed in 6 studies (1399 women). The MD was 1.73 with 95% CI of 0.81, 2.66 (P < 0.001). The number of oocytes retrieved was evaluated in 7 studies (1413 women). The MD was 1.21 with 95% CI of 0.48, 1.94 (P = 0.001).

Conclusion

This systematic review found a significant improvement of AFC, the number of retrieved oocytes, the number of cleavage embryos and the cancellation rate in women with POR.

Trial registration

Registration number CRD42022365682.

Available only for authorised users

Ansere VA, Ali-Mondal S, Sathiaseelan R, Garcia DN, Isola JVV, Henseb JD, et al. Cellular hallmarks of aging emerge in the ovary prior to primordial follicle depletion. Mech Ageing Dev. 2021;194:111425.CrossRefPubMed

Wu J, Liu Y, Song Y, Wang L, Ai J, Li K. Aging conundrum: a perspective for ovarian aging. Front Endocrinol (Lausanne). 2022;19(13):952471. https://doi.org/10.3389/fendo.2022.952471. PMID:36060963;PMCID:PMC9437485.CrossRef

Tesarik J, Galán-Lázaro M, Mendoza-Tesarik R. Ovarian aging: molecular mechanisms and medical management. Int J Mol Sci. 2021;22(3):1371.CrossRefPubMedPubMedCentral

Yan F, Zhao Q, Li Y, et al. The role of oxidative stress in ovarian aging: a review. J Ovarian Res. 2022;15:100. https://doi.org/10.1186/s13048-022-01032-x.CrossRefPubMedPubMedCentral

Maged AM, Fahmy RM, Rashwan H, et al. Effect of body mass index on the outcome of IVF cycles among patients with poor ovarian response. Int J Gynaecol Obstet. 2019;144:161–6.CrossRefPubMed

Schoolcraft W, Surrey E, Minjarez DA, Stevens JM, Gardner DK. Management of poor responders: can outcomes be improved with novel GnRH antagonist/letrozole protocol? Fertil Steril. 2009;89:151–6.CrossRef

Barrenetxea G, Agirregoikoa JA, Jimenez MR, de Larruzea AL, Ganzabal T, Carbonero K. Ovarian response and pregnancy outcome in poor responder women: a randomized controlled trial on the effect of LH supplementation on in vitro fertilization cycle. Fertil Steril. 2008;89:546–53.CrossRefPubMed

Hofmann GE, Toner JP, Muasher SJ, Jones GS. High dose follicle stimulating hormone (FSH) ovarian stimulation in low responder patient for in vitro fertilization. J In Vitro Fert Embryo Transf. 1989;6:285–9.CrossRefPubMed

Surrey ES, Bower J, Hill DM, Ramsey J, Surrey MW. Clinical and endocrine effects of a micro dose GnRH agonist flare regimen administered to poor responders who are undergoing in vitro fertilization. Fertil Steril. 1998;69:419–24.CrossRefPubMed

10.

Garcia-Valesco JA, Isaza V, Requena A, et al. High dose of gonadotropins combined with stop versus non-stop protocol of GnRH analogue administration in low responders IVF patients: a prospective, randomized controlled trial. Hum Reprod. 2000;15:2292–6.CrossRef

11.

Maged AM, Nada AM, Abohamila F, Hashem AT, Mostafa WA, Elzayat AR. Delayed start versus conventional GnRH antagonist protocol in poor responders pretreated with estradiol in luteal phase: a randomized controlled trial. Reprod Sci. 2015;22(12):1627–31. https://doi.org/10.1177/1933719115590666. Epub 2015 Jun 4 PMID: 26045549.CrossRefPubMed

12.

Kucuk T, Sozen E. Luteal start of exogenous FSH in poor responder women. J Assisst Reprod Genet. 2007;24:635–8.CrossRef

13.

National Library of Medicine. Premature ovarian failure. 2011. Retrieved January 4, 2012, from https://medlineplus.gov/primaryovarianinsufficiency.html.

14.

National Institute of child health and human development. Primary ovarian insufficiency. 2022. Last Reviewed Date 1/4/2022 from https://www.nichd.nih.gov/health/topics/poi/conditioninfo/treatments.

15.

Baba K, Yamazaki Y, Sone Y, Sugimoto Y, Moriyama K, Sugimoto T, et al. An in vitro long-term study of cryopreserved umbilical cord blood-derived platelet-rich plasma containing growth factors-PDGF-BB, TGF-β, and VEGF. J Craniomaxillofaci Surg. 2019;47(4):668–75.CrossRef

16.

Makrigiannakis A, Makrygiannakis F, Vrekoussis T. Approaches to improve endometrial receptivity in case of repeated implantation failures. Front cell Dev Biol. 2021;9:613277.CrossRefPubMedPubMedCentral

17.

Chang Y, Li J, Chen Y, Wei L, Yang X, Shi Y, et al. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization. Int J Clin Exp Med. 2015;8(1):1286–90.PubMedPubMedCentral

18.

Maleki-Hajiagha A, Razavi M, Rouholamin S, Rezaeinejad M, Maroufizadeh S, Sepidarkish M. Intrauterine infusion of autologous platelet-rich plasma in women undergoing assisted reproduction: a systematic review and meta-analysis. J Reprod Immunol. 2020;137:103078.CrossRefPubMed

19.

Maged AM, El-Mazny A, Kamal N, Mahmoud SI, Fouad M, El-Nassery N, Kotb A, Ragab WS, Ogila AI, Metwally AA, Fahmy RM, Saad H, Shaeer EM, Salah N, Lasheen Y. The value of platelet rich plasma in women with previous implantation failure. A systematic review and meta-analysis. Journal of assisted reproduction and genetics. 2023. Online ahead of print.

20.

Aflatoonian A, Lotfi M, Saeed L, Tabibnejad N. Effects of intraovarian injection of autologous platelet-rich plasma on ovarian rejuvenation in poor responders and women with primary ovarian insufficiency. Reprod Sci. 2021;28(7):2050–9. https://doi.org/10.1007/s43032-021-00483-9. Epub 2021 Mar 8 PMID: 33683669.CrossRefPubMed

21.

Barad DH, Albertini DF, Molinari E, Gleicher N. Preliminary report of intraovarian injections of autologous platelet-rich plasma (PRP) in extremely poor prognosis patients with only oocyte donation as alternative: a prospective cohort study. Hum Reprod Open. 2022;2022(3):hoac027. https://doi.org/10.1093/hropen/hoac027. PMID: 35795849; PMCID: PMC9247703.CrossRefPubMedPubMedCentral

22.

Cakiroglu Y, Saltik A, Yuceturk A, Karaosmanoglu O, Kopuk SY, Scott RT, Tiras B, Seli E. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency. Aging (Albany NY). 2020;12(11):10211–22. https://doi.org/10.18632/aging.103403. Epub 2020 Jun 5. PMID: 32507764; PMCID: PMC7346073.CrossRefPubMed

23.

Cakiroglu Y, Yuceturk A, Karaosmanoglu O, Kopuk SY, Korun ZEU, Herlihy N, Scott RT, Tiras B, Seli E. Ovarian reserve parameters and IVF outcomes in 510 women with poor ovarian response (POR) treated with intraovarian injection of autologous platelet rich plasma (PRP). Aging (Albany NY). 2022;14(6):2513–23. https://doi.org/10.18632/aging.203972. Epub 2022 Mar 22. PMID: 35320118; PMCID: PMC9004561.CrossRefPubMed

24.

Farimani M, Nazari A, Mohammadi S, Anvari AR. Evaluation of intra-ovarian platelet-rich plasma administration on oocytes-dependent variables in patients with poor ovarian response: a retrospective study according to the POSEIDON criteria. Reprod Biol Endocrinol. 2021;19(1):137. https://doi.org/10.1186/s12958-021-00826-w. Erratum in: Reprod Biol Endocrinol. 2021 Nov 18;19(1):169. PMID: 34496887; PMCID: PMC8425058.CrossRefPubMedPubMedCentral

25.

Melo P, Navarro C, Jones C, Coward K, Coleman L. The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non-randomized interventional study. J Assist Reprod Genet. 2020;37(4):855–63. https://doi.org/10.1007/s10815-020-01710-z. Epub 2020 Feb 7. PMID: 32030554; PMCID: PMC7183031.CrossRefPubMedPubMedCentral

26.

Navali N, Sadeghi L, Farzadi L, Ghasemzadeh A, Hamdi K, Hakimi P, Niknafs B. Intraovarian injection of autologous platelet-rich plasma improves therapeutic approaches in the patients with poor ovarian response: a before-after study. Int J Fertil Steril. 2022;16(2):90–4. https://doi.org/10.22074/IJFS.2021.533576.1154. Epub 2022 May 8. PMID: 35639652; PMCID: PMC9108296.CrossRefPubMedPubMedCentral

27.

Pacu I, Zygouropoulos N, Dimitriu M, Rosu G, Ionescu CA. Use of platelet-rich plasma in the treatment of infertility in poor responders in assisted human reproduction procedures. Exp Ther Med. 2021;22(6):1412. https://doi.org/10.3892/etm.2021.10848. Epub 2021 Oct 7. PMID: 34676005; PMCID: PMC8524761.CrossRefPubMedPubMedCentral

28.

Petryk N, Petryk M. Ovarian rejuvenation through Platelet-Rich Autologous Plasma (PRP)-a chance to have a baby without donor eggs, improving the life quality of women suffering from early menopause without synthetic hormonal treatment. Reprod Sci. 2020;27(11):1975–82. https://doi.org/10.1007/s43032-020-00266-8. Epub 2020 Jul 22 PMID: 32700285.CrossRefPubMed

29.

Sfakianoudis K, Simopoulou M, Grigoriadis S, Pantou A, Tsioulou P, Maziotis E, Rapani A, Giannelou P, Nitsos N, Kokkali G, Koutsilieris M, Pantos K. Reactivating ovarian function through autologous platelet-rich plasma intraovarian infusion: pilot data on premature ovarian insufficiency, perimenopausal, menopausal, and poor responder women. J Clin Med. 2020;9(6):1809. https://doi.org/10.3390/jcm9061809. PMID: 32532000; PMCID: PMC7355907.CrossRefPubMedPubMedCentral

30.

Sills JES. L, Rickers PNS, Wood SH, Li X. Regenerative effect of intraovarian injection of activated autologous platelet rich plasma: serum anti-mullerian hormone levels measured among poor-prognosis in vitro fertilization patients. Int J Regener Med. 2020:2613–5914. https://doi.org/10.31487/j.RGM.2020.01.02.

31.

Stojkovska S, Dimitrov G, Stamenkovska N, Hadzi-Lega M, Petanovski Z. Live birth rates in poor responders’ group after previous treatment with autologous platelet-rich plasma and low dose ovarian stimulation compared with poor responders used only low dose ovarian stimulation before in vitro fertilization. Open Access Maced J Med Sci. 2019;7(19):3184–8. https://doi.org/10.3889/oamjms.2019.825. PMID: 31949513; PMCID: PMC6953937.CrossRefPubMedPubMedCentral

32.

Tandulwadkar S, Karthick MS. Combined use of autologous bone marrow-derived stem cells and platelet-rich plasma for ovarian rejuvenation in poor responders. J Hum Reprod Sci. 2020;13(3):184–90. https://doi.org/10.4103/jhrs.JHRS_130_19. Epub 2020 Oct 27. PMID: 33311903; PMCID: PMC7727891.CrossRefPubMedPubMedCentral

33.

Tülek F, Kahraman A. The effects of intra-ovarian autologous platelet rich plasma injection on IVF outcomes of poor responder women and women with premature ovarian insufficiency. J Turk Ger Gynecol Assoc. 2022;23(1):14–21. https://doi.org/10.4274/jtgga.galenos.2021.2021.0134. Epub 2021 Dec 6. PMID: 34866374; PMCID: PMC8907433.CrossRefPubMedPubMedCentral

34.

Na JI, Choi JW, Choi HR, Jeong JB, Park KC, Youn SW, Huh CH. Rapid healing and reduced erythema after ablative fractional carbon dioxide laser resurfacing combined with the application of autologous platelet rich plasma. Dermatol Surg. 2011;37:463–8. https://doi.org/10.1111/j.1524-4725.2011.01916.x.CrossRefPubMed

35.

Ramaswamy Reddy SH, Reddy R, Babu NC, Ashok GN. Stem-cell therapy and platelet-rich plasma in regenerative medicines: a review on pros and cons of the technologies. J Oral Maxillofac Pathol. 2018;3:367–74. https://doi.org/10.4103/jomfp.JOMFP_93_18.CrossRef

36.

Borrione P, Gianfrancesco AD, Pereira MT, Pigozzi F. Platelet-rich plasma in muscle healing. Am J Phys Med Rehabil. 2010;89:854–61. https://doi.org/10.1097/PHM.0b013e3181f1c1c7.CrossRefPubMed

37.

Fanciulli G, Delitala A, Delitala G. Growth hormone, menopause and ageing: no definite evidence for ‘rejuvenation’ with growth hormone. Hum Reprod Update. 2009;15:341–58. https://doi.org/10.1093/humupd/dmp005.CrossRefPubMed

38.

Bakacak M, Bostanci MS, İnanc F, et al. Protective effect of platelet rich plasma on experimental ischemia/reperfusion injury in rat ovary. Gynecol Obstet Invest. 2016;81:225–31. https://doi.org/10.1159/000440617.CrossRefPubMed

39.

Panda SR, Sachan S, Hota S. A systematic review evaluating the efficacy of intra-ovarian infusion of autologous platelet-rich plasma in patients with poor ovarian reserve or ovarian insufficiency. Cureus. 2020;12(12):e12037. https://doi.org/10.7759/cureus.12037. PMID: 33457137; PMCID: PMC7797441.CrossRefPubMedPubMedCentral

Title: The value of intraovarian autologous platelet rich plasma in women with poor ovarian reserve or ovarian insufficiency: a systematic review and meta-analysis
Authors: Ahmed M. Maged
Reham A. Mohsen
Noha Salah
Wael S. Ragab
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2024
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-024-06251-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The value of intraovarian autologous platelet rich plasma in women with poor ovarian reserve or ovarian insufficiency: a systematic review and meta-analysis

Abstract

Objectives

Search strategy

Selection criteria

Data collection and analysis

Main results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Search strategy

Selection criteria

Data collection and analysis

Main results

Conclusion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2024

Analysis of risk factors of preeclampsia in pregnant women with chronic hypertension and its impact on pregnancy outcomes

Pre-pregnancy body mass index and caesarean section in Andean women in Peru: a prospective cohort study

Effect of implementation of the WHO intrapartum care model on maternal and neonatal outcomes: a randomized control trial

Improving health literacy through group antenatal care: results from a cluster randomized controlled trial in Ghana

A new step-wise surgical technique of knapsack-like uterine compression sutures for intractable postpartum hemorrhage in cesarean section

Autophagy-related biomarkers in preeclampsia: the underlying mechanism, correlation to the immune microenvironment and drug screening