Loverro Giuseppe, DI Naro Edoardo, Loverro Matteo, D'Amato Antonio, Loverro Maria T, Vitagliano Amerigo, Schounauer Luca M, Damiani Gianluca R
Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, Bari, Italy.
Unit of Obstetrics and Gynecology, Department of Biomedical and Human Oncologic Science, University of Bari, Bari, Italy -
Minerva Obstet Gynecol. 2025 Jun;77(3):192-204. doi: 10.23736/S2724-606X.24.05480-0. Epub 2024 Oct 10.
The diminished ovarian reserve (DOR) relates to a condition in which the ovary experiences a decline in its typical reproductive capacity. Despite notable advancements in understanding the pathophysiology of reduced ovarian reserve in recent years, significant unresolved challenges remain, particularly concerning the optimal therapeutic approaches for this complex condition. The main aim of this study was to investigate the potential of platelet-rich plasma (PRP) in enhancing ovarian follicle numbers by assessing changes in ovarian reserve markers.
A comprehensive literature search was conducted on the following databases: PubMed/MEDLINE, SCOPUS, The Cochrane Library, Science Direct and Web of Science. All the relevant studies published till October 2023 were screened. After removing duplicates, and full-text evaluation, 9 articles were eventually included in the present review.
The pregnancy rate (PR) among patients with poor ovarian reserve (POR) ranged from 13% to 40%, indicating the potential effectiveness of PRP as a rejuvenating treatment. The live birth rate (LBR) ranged from 13% to 20%, comparable to or not lower than the LBR of a matched healthy population aged between 38 and 42 years. Furthermore, the data presented thus far support the notion that PRP may lead to an average clinical PR of 10% in women affected by premature ovarian insufficiency (POI) and perimenopause.
PRP can not be regarded as a gamete replacement therapy, but rather as an 'additional' therapeutic tool in the management of women with DOR or POR, as well as in peri-menopausal women. Additional qualitative studies are required to validate the existing evidence, as the literature currently lacks randomized controlled trials (RCTs) in this regard.
卵巢储备功能减退（DOR）是指卵巢的典型生殖能力下降的一种状况。尽管近年来在理解卵巢储备功能降低的病理生理学方面取得了显著进展，但仍存在重大的未解决挑战，尤其是关于这种复杂状况的最佳治疗方法。本研究的主要目的是通过评估卵巢储备标志物的变化来研究富血小板血浆（PRP）在增加卵巢卵泡数量方面的潜力。
对以下数据库进行了全面的文献检索：PubMed/MEDLINE、SCOPUS、Cochrane图书馆、Science Direct和科学网。筛选了截至2023年10月发表的所有相关研究。在去除重复项并进行全文评估后，最终有9篇文章纳入本综述。
卵巢储备功能不良（POR）患者的妊娠率（PR）在13%至40%之间，表明PRP作为一种恢复活力的治疗方法具有潜在效果。活产率（LBR）在13%至20%之间，与年龄在38至42岁的匹配健康人群的LBR相当或不低于该水平。此外，目前呈现的数据支持这样一种观点，即PRP可能使受卵巢早衰（POI）和围绝经期影响的女性的平均临床PR达到10%。
PRP不能被视为一种配子替代疗法，而应被视为管理DOR或POR女性以及围绝经期女性的“额外”治疗工具。由于目前文献中缺乏这方面的随机对照试验（RCT），因此需要更多定性研究来验证现有证据。
