Davari Tanha Fatemeh, Salimi Setudeh Shohreh, Ebrahimi Mahbod, Feizabad Elham, Khalaj Sereshki Zahra, Akbari Asbagh Firoozeh, Pakniat Hamideh, Khalili Azadeh, Kaveh Zahra, Saeedi Sara
Department of Infertility, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Caspian J Intern Med. 2023 Summer;14(3):485-489. doi: 10.22088/cjim.14.3.485.
Poor ovarian responder (POR) women, whose ovarian response to gonadotropin stimulation has decreased, are at higher risk of unsuccessful in-vitro fertilization (IVF). Therefore, this study designed to evaluate the effect of intra-ovarian platelet rich plasma (PRP) on POR women.
This single-arm trial research was done on 20 POR women referred to the IVF Unit, university-based hospital, Tehran, Iran between October 2020 and September 2021. For all participants, autologous PRP was injected into each ovary by transvaginal ultrasound guidance under spinal anesthesia between days 12 and 14 of the menstrual cycle. After 12 weeks of PRP injection, embryo transfers were carried out following our routine IVF department protocol. The study outcomes were the number of mature oocytes, and pregnancy rates.
The average age of the participants was 41.80±1.82 yr. The average infertility duration was 9.70±1.89 yrs., with 80% primary infertility type. After PRP injection, follicle-stimulating hormone levels dropped about 1% (P=0.499), anti-Mullerian hormone levels were on average 4.5% higher (P=0.356), and estradiol levels raised by 1.2% (P=0.681). The average number of oocytes and their quality increased after PRP injection, while these changes were not significant (p-value>0.05). Chemical pregnancy was detected in 3 (15%) women and clinical pregnancy was detected only in one person.
This study revealed that PRP injection into ovaries of POR women is safe and had a tendency to improve ovarian reserve markers and serum levels of AMH, estradiol, number and quality of oocytes.
卵巢低反应（POR）女性对促性腺激素刺激的卵巢反应降低，其体外受精（IVF）失败的风险更高。因此，本研究旨在评估卵巢内注射富血小板血浆（PRP）对POR女性的影响。
本单臂试验研究于2020年10月至2021年9月在伊朗德黑兰一家大学附属医院的IVF科对20名POR女性进行。对于所有参与者，在月经周期的第12至14天，于脊髓麻醉下经阴道超声引导将自体PRP注入每个卵巢。PRP注射12周后，按照我们IVF科的常规方案进行胚胎移植。研究结果为成熟卵母细胞数量和妊娠率。
参与者的平均年龄为41.80±1.82岁。平均不孕年限为9.70±1.89年，其中80%为原发性不孕类型。PRP注射后，促卵泡激素水平下降约1%（P=0.499），抗苗勒管激素水平平均升高4.5%（P=0.356），雌二醇水平升高1.2%（P=0.681）。PRP注射后卵母细胞的平均数量及其质量有所增加，但这些变化不显著（p值>0.05）。3名（15%）女性检测到化学妊娠，仅1人检测到临床妊娠。
本研究表明，向POR女性卵巢内注射PRP是安全的，并且有改善卵巢储备指标以及AMH、雌二醇的血清水平、卵母细胞数量和质量的趋势。
