Intraovarian platelet-rich plasma: follicular reactivation improves the response to ovarian stimulation in assisted reproduction.

Abstract

Objective: can the intraovarian application o fplatelet-rich plasma increase the number ofoocytes obtained in in vitro fertilization treatments? Summary answer: The intraovarian application of PRP successfully increased the number of retrieved oocytes What is knownalready:The decrease in oocyte quantity and quality directly impacts the response to controlled ovarian stimulation in assisted reproduction treatments. The use of intraovarian platelet- rich plasma has been proposed to stimulate angiogenesis, promote cell proliferation, and follicular reactivation, with the aimof improving ovarian response. Studydesign:This prospective, controlled, non-randomized cohort study. Materials and methods: included 32 patients who were divided in to three age groups (<35; 36-39; and 40-44 years). Platelet-Rich Plasma (PRP) was prepared using sequential centrifugation and injected in to the ovarian. Data were analyzed using a Generalized Linear Mixed Model (GLMM) with a Poisson distribution. Mainresults: The age group<35 years didnot show a significant difference; this could be due to the low number of patients. Limitations: Prior to PRP administration, 42.9% of cases failed toyield any oocytes, with 57.1% retrieving. After the procedure, the percentage of failed retrievals fell sharply to only 11.8%, increasing the overall success rate to 88.2% (P<0.05). FSH exhibited the highest predictive capacity for oocyte retrieval at 78.07%, follow edby AFC at 74.01% and AMH at 68.05%. The PRP intervention resulted in a statistically significant increase in both the total oocyte yield and mature (M2) oocyte counts (P < 0.01). Oocyte yield improved across all cohorts, with the 36-39 and 40-44 year groups demonstrating significant differences (P<0.001 and P=0.0308, respectively). Wider implications of the findings: FSH and AFC as predictors of ovarian response are effective. Althoug hall age groups benefited, It is important to rule out embryonic aneuploidies to improve reproductive outcomes.