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Effects of Intraovarian Injection of Autologous Platelet-Rich Plasma on Ovarian Rejuvenation in Poor Responders and Women with Primary Ovarian Insufficiency

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Abstract

Injection of intraovarian platelet-rich plasma (PRP) was recently presented in terms of improvement ovarian function in women with a poor ovarian response (POR) or primary ovarian insufficiency (POI). In a before and after study, 17 poor responder women and 9 women with the diagnosis of POI were recruited. The multifocal intramedullary infusion of 1.5 ml activated PRP was performed into each ovary. The majority of women in both groups received the second PRP injection with the twofold increase in the dosage to 3ml, 3 months after the first injection. Evaluation of serum anti-mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) was performed. In addition, all women were followed with regard to pregnancy outcome up to delivery. In the POI group, menstrual restoration was monitored. The significant difference was not detected regarding the hormonal profile between the three time points in both groups. With regard to pregnancy outcome, 8/17 (47%) of PORs had spontaneous pregnancy in response to PRP injection. Of those, three women (37.55%) had abortions, whereas 4 pregnancies (50%) led to healthy live births, and one woman (12.5%) was in the 24th week of her pregnancy. Menstruation recovery occurred among 22.2% of women with POI after the second PRP injection, but no one became pregnant. Intraovarian injection of autologous PRP might be considered an alternative treatment in poor responders. As for women with POI, it is questionable whether PRP could induce menstrual recovery.

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Acknowledgements

The authors thank Dr. Hossein Falahzadeh, Professor of Biostatistics, for the statistical assistance. We acknowledge the Hormone laboratory group and operating room personnel at the Yazd Reproductive Sciences Institute for their great contribution to the entire laboratory work and data gathering.

Code Availability

The Ethics Code and IRCT Code are available.

Funding

The research leading to these results received funding from Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, under Grant Agreement No. 68876.

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Authors and Affiliations

  1. Research and Clinical Centre for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Abbas Aflatoonian & Nasim Tabibnejad

  2. Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Marzieh Lotfi

  3. Department of Medical Genetics, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Marzieh Lotfi

  4. Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran

    Lida Saeed

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  1. Abbas Aflatoonian
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  3. Lida Saeed
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  4. Nasim Tabibnejad
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Contributions

Abbas Aflatoonian and Marzieh Lotfi conceived and designed the study. Abbas Aflatoonian and Lida Saeed performed the experiments. Marzieh Lotfi and Nasim Tabibnejad gathered and analyzed the data, wrote the draft, and revised the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Marzieh Lotfi or Lida Saeed.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran (IR.SSU.RSI.REC.1397.004).

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A written informed consent for participating in this trial was obtained from all patients.

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Patients signed informed consent regarding publishing their data.

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The authors declare no competing interests.

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Aflatoonian, A., Lotfi, M., Saeed, L. et al. Effects of Intraovarian Injection of Autologous Platelet-Rich Plasma on Ovarian Rejuvenation in Poor Responders and Women with Primary Ovarian Insufficiency. Reprod. Sci. 28, 2050–2059 (2021). https://doi.org/10.1007/s43032-021-00483-9

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  • DOI: https://doi.org/10.1007/s43032-021-00483-9

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