Evaluation of the impact of platelet-rich plasma in women with reduced ovarian reserve

Year 2022, Volume: 5 Issue: 5, 1334 - 1338, 25.09.2022

Naziye Gürkan , Nur Dokuzeylül Güngör , Asena Ayar Madenli , Şebnem Alanya Tosun

https://doi.org/10.32322/jhsm.1117530

Abstract

Introduction: Infertility is the most critical factor disrupting the marital relationship, which imposes high financial and psychological costs on couples. Despite vast advances, the problem of infertility has not yet been entirely resolved. The new method of injecting platelet-rich plasma (PRP) has been promising for couples. This study investigated the effect of PRP injection on the fertility of infertile women.
Material and Method: In this study, 40 women with a history of infertility with a mean age of 37.75 were included in the study. Prior to the demographic information intervention, laboratory findings, including serum anti-mullerian hormone (AMH) levels and ultrasound for the number of antral follicles count (AFC) were performed. Autologous PRP was then prepared for each patient, and an intraovarian injection was performed. Two months after injection, serum levels of AMH and AFC levels were re-evaluated.
Results: The mean AMH levels before and after the injection were 0.07±0.05 and 0.13±0.06, respectively (p<0.001). The mean follicle-stimulating hormone (FSH) levels before and after the injection were 33.95±12.59 and 22.10±3.29, respectively (p <0.001). The amount of AFC increase one number after the injection. Linear regression showed that patient and partner age, body mass index (BMI) and infertility years had no effect on PRP injection response. PRP is associated with a significant increase in AMH levels, decrease in FSH levels and a significant increase in the number of AFCs. Patient and partner age, BMI and infertility years have no effect on response to PRP injection.
Conclusion: This study showed that the PRP injection improving ovarian reserve markers as measured by AMH and FSH serum levels, and AFC. However, further studies should be done to assess the effect of PRP on pregnancy outcomes.

Keywords

Infertility, platelet-rich plasma, follicle-stimulating hormone, antral follicle count, anti mullerian hormone

References

• Brandt JS, Cruz Ithier MA, Rosen T, Ashkinadze E. Advanced paternal age, infertility, and reproductive risks: A review of the literature. Prenat Diagn 2019; 39: 81-7.
• Jirge PR. Poor ovarian reserve. Journal of human reproductive sciences 2016; 9: 63.
• American College of Obstetricians and Gynecologists Committee on Gynecologic Practice and Practice Committee. Female age-related fertility decline. Committee Opinion No. 589. Fertil Steril 2014; 101: 633-4.
• Jabeen F, Khadija S, Daud S. Prevalence of Primary and Secondary Infertility. Saudi J Med 2022; 7: 22-8.
• Iino K, Fukuhara R, Yokota M, Yokoyama Y. Fertility awareness and subclinical infertility among women trying to get pregnant at home. BMC Womens Health 2022; 22 :43.
• Seli E. Ovarian Aging. Semin Reprod Med 2015; 33: 375-6.
• Carson SA, Kallen AN. Diagnosis and Management of Infertility: A Review. JAMA 2021; 326: 65-76.
• Donders GGG, Ruban K, Bellen G, Grinceviciene S. Pharmacotherapy for the treatment of vaginal atrophy. Expert Opin Pharmacother 2019; 20: 821-35.
• Quaas, AM, Legro RS. Pharmacology of medications used for ovarian stimulation. Best Pract Res Clin Endocrinol Metab 2019; 33: 21-33.
• Sánchez-González DJ, Méndez-Bolaina E, Trejo-Bahena NI. Platelet-rich plasma peptides: key for regeneration. Int J Pept 2012; 2012: 532519.
• Sharara FI, Lelea LL, Rahman S, Klebanoff JS, Moawad GN. A narrative review of platelet-rich plasma (PRP) in reproductive medicine. J Assist Reprod Genet 2021; 38: 1003-12.
• Coksuer, H, Akdemir Y, and Ulas Barut M. Improved in vitro fertilization success and pregnancy outcome with autologous platelet-rich plasma treatment in unexplained infertility patients that had repeated implantation failure history. Gynecological Endocrinol 2019; 35: 815-8.
• Stojkovska S, Gligor D, Petanovski, et al. Novel method of treating ovarian infertility: is platelet-rich plasma a new promising therapy in the future? Macedonian Med Rev 2019; 73: 101-5.
• Sills ES, Rickers NS, Li X, Palermo GD. First data on in vitro fertilization and blastocyst formation after intraovarian injection of calcium gluconate-activated autologous platelet rich plasma. Gynecol Endocrinol 2018; 34: 756-60.
• Sills ES, Rickers NS, Petersen JL, Li X, Wood SH. Regenerative effect of intraovarian injection of autologous platelet rich plasma: Serum anti-Mullerian hormone levels measured among poor-prognosis in vitro fertilization patients. Int J Regen Med 2020; 3: 1-5.
• Sfakianoudis K, Simopoulou M, Nitsos N, et al. A Case series on platelet-rich plasma revolutionary management of poor responder patients. Gynecol Obstet Invest 2019; 84: 99-106.
• Sfakianoudis K, Simopoulou M, Grigoriadis S, et al. 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: 1809.
• 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: 1412.
• Cakiroglu Y, Yuceturk A, Karaosmanoglu O, et al. 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: 2513-23.
• 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: 855-63.
• Pantos K, Simopoulou M, Pantou A, et al. A case series on natural conceptions resulting in ongoing pregnancies in menopausal and prematurely menopausal women following platelet-rich plasma treatment. Cell Transplant 2019; 28: 1333-40.
• Hsu CC, Hsu L, Hsu I, Chiu YJ, Dorjee S. Live birth in woman with premature ovarian insufficiency receiving ovarian administration of platelet-rich plasma (PRP) in combination with gonadotropin: a case report. Front Endocrinol (Lausanne) 2020; 19; 11-50.
• Cakiroglu Y, Saltik A, Yuceturk A, et al. 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: 10211-22.
• Chang Y, Li J, Chen 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: 1286-90.