Sadeghpour Sonia, Maleki Farzad, Hajizadeh-Sharafabad Fatemeh, Ghasemnejad-Berenji Hojat
Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran.
Department of Obstetrics and Gynecology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Eur J Med Res. 2025 Jul 10;30(1):610. doi: 10.1186/s40001-025-02854-3.
The objective of this study was to evaluate the effect of the intraovarian injection of platelet-rich plasma (PRP) on ovarian reserve and reproductive outcomes in patients with premature ovarian insufficiency (POI) and poor ovarian response (POR).
The study registered in the PROSPERO database adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Web of Science, Scopus, Google Scholar, and ClinicalTrials.gov databases were searched from inception to June 2024-23 studies included in the meta-analysis. A total of 1853 participants aged 29.8-45 years old were included in the meta-analysis. The human studies reporting the effect of intraovarian PRP injection on ovarian reserve indicators were included in the meta-analysis. The quality of the included studies was assessed using the Cochrane Handbook or the Newcastle-Ottawa scale. The primary outcomes were serum levels of anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), Estradiol, and antral follicle count (AFC), number of retrieved oocytes, metaphase II (M2) oocytes, and pregnancy and live birth rates.
RESULT(S): The pooled analysis of the included studies showed that intraovarian PRP injection significantly increased oocyte number (WMD: 0.97, 95% CI 0.58, 1.35, P < 0.001), M2 oocyte number (WMD: 0.80, 95% CI 0.33, 1.27, P < 0.001), AFC (WMD: 1.64, 95% CI 0.90, 2.38, P < 0.001), and AMH levels (WMD: 0.12 ng/mL, 95% CI 0.07, 0.17, P < 0.001) in women with POR. Besides, in women with POI, PRP injection significantly improved AFC (WMD: 1.33, 95% CI 1.19, 1.47, P < 0.001) and serum levels of FSH (WMD: - 15.68 IU/mL, 95% CI - 24.12, - 7.24, P < 0.001), AMH (WMD: 0.29 ng/mL, 95% CI 0.08, 0.49, P = 0.006), and LH (WMD: - 9.87 IU/mL, 95% CI - 15.23, - 4.51, P < 0.001). The meta-analysis revealed a pregnancy ratio of 0.21 and a live birth ratio of 0.18 in women with poor ovarian reserve after PRP injection. In women with POI, the figures were marginally lower, recorded as 0.138 for pregnancy and 0.10 for live birth, respectively.
PRP may serve as an alternative therapy for POI and POR; however, further investigation is required to validate its efficacy and determine suitable candidates.
本研究的目的是评估卵巢内注射富血小板血浆（PRP）对卵巢储备功能不全（POI）和卵巢反应不良（POR）患者的卵巢储备和生殖结局的影响。
在PROSPERO数据库中注册的本研究遵循系统评价和Meta分析的首选报告项目指南。检索了PubMed、科学网、Scopus、谷歌学术和ClinicalTrials.gov数据库，从数据库建立至2024年6月，共纳入23项Meta分析研究。Meta分析共纳入1853名年龄在29.8至45岁之间的参与者。纳入报告卵巢内注射PRP对卵巢储备指标影响的人体研究进行Meta分析。使用Cochrane手册或纽卡斯尔-渥太华量表评估纳入研究的质量。主要结局指标为抗苗勒管激素（AMH）、促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇的血清水平、窦卵泡计数（AFC）、获卵数、中期II（M2）期卵母细胞数以及妊娠率和活产率。
纳入研究的汇总分析表明，卵巢内注射PRP可显著增加POR女性的卵母细胞数（加权均数差：0.97，95%可信区间0.58，1.35，P<0.001）、M2期卵母细胞数（加权均数差：0.80，95%可信区间0.33，1.27，P<0.001）、AFC（加权均数差：1.64，95%可信区间0.90，2.38，P<0.001）和AMH水平（加权均数差：0.12 ng/mL，95%可信区间0.07，0.17，P<0.001）。此外，在POI女性中，PRP注射可显著改善AFC（加权均数差：1.33，95%可信区间1.19，1.47，P<0.001）以及FSH（加权均数差：-15.68 IU/mL，95%可信区间-24.12，-7.24，P<0.001）、AMH（加权均数差：0.29 ng/mL，95%可信区间0.08，0.49，P=0.006）和LH（加权均数差：-9.87 IU/mL，95%可信区间-15.23，-4.5,1，P<0.001）血清水平。Meta分析显示，PRP注射后卵巢储备功能不良女性的妊娠率为0.21，活产率为0.18。在POI女性中，这些数字略低，妊娠率为0.138，活产率为0.10。
PRP可能是POI和POR的一种替代治疗方法；然而，需要进一步研究以验证其疗效并确定合适的候选者。
