Intraovarian platelet-rich plasma injection in poor responders

Objective: To evaluate if it possible to improve ovarian reserve parameters and oocyte retrieval in poor responders who undergo intraovarian injection of platelet-rich plasma (PRP). Methods: Prospective cohort study. We included 148 poor responders who underwent PRP injection between October 2021 and December 2022 in our institution, comparing pre and post PRP ovarian function. In addition, the IVF outcomes of a subgroup of patients was studied after the intervention in contrast with the previous treatment. Results: An improvement in ovarian reserve was observed in relation to previous values: FSH (13.57 vs. 11.32, p =0.11), AMH (0.39 vs. 0.48, p =0.06), antral follicle count (3.98 vs . 5.75, p <0.001); as well as a higher number of oocytes retrieved (2.63 vs . 3.65, p =0.01) and produced embryos (1.64 vs . 2.22, p =0.03); without a great impact on pregnancy rates. Conclusions: Although experimental, intraovarian PRP could restore ovarian function and be postulated as an alternative to oocyte donation in patients with low ovarian reserve who do not accept this treatment. There is a lack of randomized controlled trials to support these findings.