A report on three live births in women with poor ovarian response following intra-ovarian injection of platelet-rich plasma (PRP).

The prevalence of poor response to gonadotropin stimulation is approximately 9-24% in women undergoing in vitro fertilization. Interestingly, due to containing a variety of growth factors, platelet-rich plasma (PRP) can play an important role in tissue regeneration and healing. Thus, in this research, we aimed to investigate the intra-ovarian injection of PRP in women with poor ovarian response. To this goal, 23 poor responders constituted the study population, from among whom 19 women were enrolled. These patients underwent ovarian stimulation according to the Shanghai protocol. Immediately after the first follicular puncture, 2 mL of PRP was injected into each ovary. 1 day after the first puncture and PRP injection, the second stimulation was initiated. Then, oocyte retrieval was followed. About 2-3 months after the first cycle, the patients underwent another treatment with ovarian stimulation according to the Shanghai protocol and then, follicular puncture was performed. The mean numbers of oocytes before and after PRP injection were 0.64 and 2.1, respectively. Two patients experienced spontaneous conceptions. The third case achieved clinical pregnancy and delivered a healthy baby in June 2018. The results of this study appeared to be the first report on the effects of intra-ovarian PRP injection on the increase of ovarian responses, even on the spontaneous conceptions of women with poor ovarian response.