Effect of autologous platelet rich plasma on anti-mullerian hormone and antral follicle count in sub fertile women with poor ovarian reserve

Muhammad J. Uddin, Jesmine Banu, Shakeela Ishrat, Sabiha Sultana, Serajoom Munira, Mehnaz M. Shume, Sheikh F. Huda


Background: Ovarian aging may be reversible. Platelet rich plasma (PRP) has growth factors that promote cellular proliferation and folliculogenesis. Recently published studies and case reports suggest that ovarian rejuvenation can be done by PRP treatment. The objective of the study was to evaluate the effect of platelet rich plasma on ovarian reserve markers such as anti mullerian hormone (AMH) and antral follicle count (AFC) in sub fertile women with poor ovarian reserve (POR).

Methods: The self-controlled quasi experimental study was carried out on 29 sub fertile women with poor ovarian reserve. They were selected for laparoscopic tubo-peritoneal evaluation as they could not afford in vitro fertilization. During laparoscopy, 5 ml of pre prepared autologous PRP was injected into each ovary. Post-PRP AMH and AFC were measured at every cycle for a period of at least three (3) months and compared with base line values.

Results: Mean age of participants was 35.9±3.2 years. Baseline AMH was 0.31±0.17 ng/ml and baseline AFC was 3.41±0.73. AMH was raised on first, second and third cycle from base line values in 58.62%, 86.21% and 91.30% of the study population respectively. AMH changes in all three cycle were statistically significant. Pregnancy occurred in three (10.34%) women during the study period.

Conclusions: The injection of autologous PRP into human ovaries is a safe procedure to improve ovarian reserve markers (AMH and AFC) in women with POR.


Poor ovarian reserve, Platelet rich plasma, Anti-mullerian hormone, Antral follicle count

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Jirge RP. Poor ovarian reserve. J Hum Reprod Sci. 2016;9(2):1-13.

Zukerman S. The number of oocytes in the mature ovary. Rec Prog Horm Res. 1951;6:63.

Johnson J, Canning J, Kaneko T, Pru JK, Tilly JL. Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature. 2004;428:145-50.

Tilly JL, Telfer EE. Purification of germinal stem cells from adult mammalian ovaries: a step closer towards control of the female biological clock. Mol Hum Reprod. 2010;15:393-8.

Niikura Y, Niikura T, Tilly JL. Aged mouse ovaries possess rare premeiotic germ cells that can generate oocytes following transplantation into a young host environment. Aging. 2009;1:971-8.

Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Autologous platelets as a source of proteins for healing and tissue regeneration .Thromb Haemost. 2004;91:4-15.

Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, RodeoSA. Platelet-rich plasma: from basic science to clinical applications. Am J Sport Med. 2009;37:2259-72.

Amable PR, Carias RB, Teixeira MB, Pacheo IC, Amaral RJFC, Granjeiro JM et al. Platelet rich plasma preparation for regenerative medicine: optimization and quantification of cytokines and growth factors. Stem Cell Res Ther. 2013;4(67):1-13.

Callejo J, Salvador C, Gonzalez- Nunez S, Almeida L, Rodriguez L. Live birth in a woman without ovaries after autograft of frozen-thawed ovarian tissue combined with growth factors. J Ovarian Res. 2013;6(33):1-6.

Pantos K, Nitsos N, Kokkali G, Vaxevanoglou T, Marcomichali C, Pantou A, et al. Ovarian rejuvenation and folliculogenesis reactivation in peri-menopausal women after autologous platelet-rich plasma treatment. Proceedings of the 32nd Annual Meeting of ESHRE; 2016 July 3-6; Helsinki, Finland. Hum Reprod. 2016;1:301.

Sills ES, Rickers NS, Li X, Palermo GD. First data on in vitro fertilization and blastocyst formation after intraovarian injection of calcium gluconate- activated autologous platelet rich plasma. Gynecol Endocrinol. 2018;28:1-5.

Salih MA, Hossein OM, Aldin AT, Hamad MN, et al. Correlation between antimullerian hormone level before and after laparoscopic ovarian autologous PRP injections. Evid Based Women’s Health J. 2019;10(1):89-94.

Melo P, Navarro C, Jones C, Coward K, Coleman L. The use of autologous platelet – rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non- randomized interventional study. J Assist Reprod Genet. 2020;37:55-863.

Sfakianoudis K, Simopoulou M, Grigoriasdia S, Panttou A, et al. Reactivating ovarian function through autologous platelet-rich plasma intraovarian infusion: pilot data on premature ovarian insufficiency, perimenopausal, menopausal and poor responder women. J Clin Med. 2020;9(1829):1-25.

Ishrat S, Deeba F, Anwary SA, Banu J. Correlation and discordance of anti-mullerian hormone with follicle stimulating hormone in infertile women with premature ovarian insufficiency and diminished ovarian reserve. Int J Reprod Contracept Obstet Gynecol. 2021;10(1):32-8.

Ferrareti AP, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli I. ESHRE Working Group on Poor Ovarian Response Definition. ESHRE consensus and the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: The Bologna Criteria. Hum Reprod. 2011;26:1616-24.

Surekha T, Himabindu Y, Sriharibabu M. Impact of socio-economic status on ovarian reserve markers. J Hum Reprod Sci. 2013;6(3):201-4.

Cakiroglu Y, Saltik A, Yuceturk A, Karaosmanoglu O, Kopuk SY, et al. Effect of intra-ovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency. Aging Res. 2020;12(11):10211-21.