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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

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Abstract

Purpose

To investigate the impact of a 3-month course of intracortical injections of autologous platelet-rich plasma (PRP) upon ovarian reserve markers versus no intervention in women with low ovarian reserve prior to undergoing assisted reproductive technology (ART).

Methods

Prospective controlled, non-randomized comparative study conducted in a private fertility clinic, in Venezuela. Women with abnormal ovarian reserve markers (FSH, AMH and AFC) who declined oocyte donation were allocated to one of the following groups according to patient choice: monthly intracortical ovarian PRP injections for three cycles, or no intervention. Primary outcomes were the change in FSH, AMH and AFC pre- and post-treatment. Secondary outcomes included the number of oocytes collected and fertilized, biochemical/clinical pregnancy rates and miscarriage and live birth rates.

Results

Eighty-three women were included, of which 46 received PRP treatment and 37 underwent no intervention. Overall median age was 41 years (IQR 39–44). There were no demographic differences between the study groups. At the 3-month follow-up, women treated with PRP experienced a significant improvement in FSH, AMH and AFC, whereas there was no change in the control group. Furthermore, overall rates of biochemical (26.1% versus 5.4%, P = 0.02) and clinical pregnancy (23.9% versus 5.4%, P = 0.03) were higher in the PRP group, while there was no difference in the rates of first trimester miscarriage and live birth between groups.

Conclusion

PRP injections are effective and safe to improve markers of low ovarian reserve prior to ART, although further evidence is required to evaluate the impact of PRP on pregnancy outcomes.

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Author information

PM contributed to the study design, data analysis and interpretation and drafted the manuscript. CN contributed to the study design and implementation, patient recruitment, PRP administration, data acquisition and critically revised the manuscript. CJ contributed to the study design and critically revised the manuscript. KC contributed to the study design and critically revised the manuscript. LC developed the concept and design of the study and had overall responsibility for trial registration, seeking ethical approval, data collection and interpretation, manuscript drafting and critical revisions. All authors critically revised the article for intellectual content and gave final approval. All authors accept responsibility for the paper as published.

Correspondence to P. Melo.

Ethics declarations

This study was designed, conducted and reported in accordance with the principles of Good Clinical Practice guidance and with the 1964 Helsinki declaration and its later amendments. Prospective ethical approval was granted by a local Institutional Review Board (IRB) and the Venezuelan Health Ministry (IRB reference number #0940), and written consent was obtained from all participants.

Conflict of interest

The authors declare that they have no conflict of interest.

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Melo, P., Navarro, C., Jones, C. et al. 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). https://doi.org/10.1007/s10815-020-01710-z

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Keywords

  • Platelet-rich plasma
  • Ovarian reserve
  • Assisted reproductive techniques
  • Pregnancy outcome