The outcome of ovarian rejuvenation by PRP in Poor responder patients

Poor ovarian reserve (POR) is a challenging condition in assisted reproductive technology (ART), with a reported prevalence of 9 to 24 percent among women undergoing in vitro fertilization (IVF), depending on the diagnostic criteria applied. Affected individuals typically present with reduced oocyte yield, compromised embryo quality, and markedly lower live birth rates, which in severe cases may be as low as 2 to 8 percent per cycle. Existing treatment strategies, including high-dose gonadotropins and various adjuvant therapies, have demonstrated limited and inconsistent success in improving outcomes. Consequently, there is a pressing need for novel, evidence-based interventions to support this patient population. Intraovarian injection of autologous platelet-rich plasma (PRP) has recently gained attention as a potential regenerative therapy. PRP is rich in bioactive growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-beta), which may enhance follicular activation, angiogenesis, and tissue repair when injected directly into the ovaries. Preliminary studies have reported improvements in ovarian reserve markers, including anti-Mullerian hormone (AMH) and antral follicle count (AFC), as well as encouraging trends in IVF outcomes following PRP treatment in women with POR and premature ovarian insufficiency. However, the current evidence is largely derived from small-scale, non-randomized studies, underscoring the need for rigorous clinical trials to validate its safety and efficacy.

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