Merhi Zaher, Mouanness Marco, Wang Ruoyu, Seckin Serin
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA.
Rejuvenating Fertility Center, New York, NY 10019, USA.
JCEM Case Rep. 2023 Apr 21;1(2):luad038. doi: 10.1210/jcemcr/luad038. eCollection 2023 Mar.
The use of platelet-rich plasma (PRP) has become popular as an adjunct to fertility treatment for women with infertility, particularly those with low ovarian reserve and premature ovarian insufficiency. Recent data in a polycystic ovary syndrome (PCOS) animal model demonstrated that intraovarian PRP administration improved folliculogenesis, ovarian antioxidant potential, and serum hormonal imbalance, suggesting that PRP could be considered a novel technique to alleviate PCOS-induced pathogenesis. With injection of PRP into the ovaries, it has been hypothesized that the infusion of cytokines and growth factors may exhibit a local effect that changes the expression of genes important in folliculogenesis and steroidogenesis, decreases inflammation, and partially restores normal ovarian function. This report is the first to present a case of a long-term amenorrheic woman with PCOS who has been trying to conceive, who resumed spontaneous ovulatory cycles, and had improvement in several aspects of her hormonal imbalance following intraovarian PRP administration. The purpose of this case report is to increase awareness regarding the possible benefits of intraovarian PRP injections for women with PCOS. There is a clear need for larger prospective studies to properly elucidate the effect of intraovarian PRP administration on both the reproductive and metabolic dysfunctions observed in women with PCOS.
富血小板血浆(PRP)的应用已成为治疗不孕症女性(尤其是卵巢储备功能低下和卵巢早衰患者)的辅助生育手段。多囊卵巢综合征(PCOS)动物模型的最新数据表明,卵巢内注射PRP可改善卵泡生成、卵巢抗氧化能力及血清激素失衡,提示PRP可被视为一种缓解PCOS所致发病机制的新技术。通过将PRP注入卵巢,有人推测细胞因子和生长因子的注入可能产生局部效应,改变卵泡生成和类固醇生成中重要基因的表达,减轻炎症,并部分恢复正常卵巢功能。本报告首次呈现了一例患有PCOS且长期闭经、一直尝试受孕的女性病例,该女性在接受卵巢内PRP注射后恢复了自发排卵周期,且激素失衡的多个方面均有改善。本病例报告的目的是提高人们对卵巢内PRP注射对PCOS女性可能带来的益处的认识。显然,需要开展更大规模的前瞻性研究,以恰当阐明卵巢内注射PRP对PCOS女性所观察到的生殖和代谢功能障碍的影响。