Efficacy of autologous platelet rich plasma for ovarian rejuvenation in infertile women having poor ovarian reserve


  • Jesmine Banu Department of Reproductive Endocrinology and Infertility, BSMMU, Dhaka, Bangladesh
  • Mostafa Tarique Department of Reproductive Endocrinology and Infertility, BSMMU, Dhaka, Bangladesh
  • Nishat Jahan Department of Gynecology, Nabinagar Upazila Health Complex, Brahmanbaria, Bangladesh
  • Nastaran Lasker Department of Reproductive Endocrinology and Infertility, BSMMU, Dhaka, Bangladesh
  • Nighat Sultana Department of Reproductive Endocrinology and Infertility, BSMMU, Dhaka, Bangladesh
  • Chowdhury Faisal Alamgir Department of Urology, New Cross Hospital, The Royal Wolverhampton NHS Trust, United Kingdom
  • Maliha Darmini Department of Gynecology, Mymensingh Medical College and Hospital, Mymensingh, Bangladesh
  • Sirajum Munira Department of Reproductive Endocrinology and Infertility, BSMMU, Dhaka, Bangladesh




Infusion, Platelet, Plasma, Rejuvenation, Ovarian, Infertile


Background: Poor ovarian reserve (POR) is a condition in which the ovary loses its normal reproductive potential and compromising fertility. Normal function of the ovaries and adequate good quality follicles are responsible for the reproductive process of a woman. Various treatment methods exist for POR, but the present study was conducted to observe the effectiveness of platelet rich plasma infusion through measurement of AMH and AFC values and pregnancy outcomes.

Methods: This prospective observational study was done in the department of reproductive endocrinology and infertility from July 2019 to June 2022. A total of 60 patients with poor ovarian reserve were recruited maintaining inclusion and exclusion criteria.

Results: Mean age of the participants was 36.4 years, with 78.32% of the participants being housewives and 21.68% being service workers. 65.38% had education below SSC levels. 72.46% had primary infertility while 27.54% had secondary infertility. At first cycle, compared to baseline counts, mean±SD AMH had increased by 0.04±0.15 ng/dl, and mean±SD AFC had increased by 1.34±1.89 in number. During second cycle post-PRP, the mean difference of AMH and AFC was 0.18±0.21 ng/dl and 2.17±1.71 in a positive manner. By final follow-up, pregnancy rate was 20% among patients.

Conclusions: The study observed significant improvement in AMH and AFC values following PRP infusion. The improvement of both values was gradual, and increase of AMH values were observed up to second post-PRP menstrual cycle, while AFC increased till third cycle post-PRP. Among 60 patient twelve (12) had pregnancy (20%).


Seli E. Ovarian aging. Semin Reproduct Med. 2015;33(6):375-6.

Practice Committee of the American Society for Reproductive Medicine. Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 2020;114(6):1151-7.

Kasapoğlu I, Seli E. Mitochondrial dysfunction and ovarian aging. Endocrinology. 2020;161(2).

Ferraretti A, LaMarca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L, et al. ESHRE consensus on the definition of ‘poor response'to ovarian stimulation for in vitro fertilization: the Bologna criteria. Human Reproduct. 2011;26(7):1616-24.

Alviggi C, Esteves SC, Orvieto R, Conforti A, LaMarca A, Fischer R, et al. POSEIDON (Patient-oriented strategies encompassing individualized oocyte number) group. COVID-19 and assisted reproductive technology services: repercussions for patients and proposal for individualized clinical management. Reprod Biol Endocrinol. 2020;18(1):45.

Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birth in IVF treatment: an analysis of 400 135 treatment cycles. Human Reproduct. 2011;26(7):1768-74.

Polyzos NP, Drakopoulos P, Parra J, Pellicer A, Santos-Ribeiro S, Tournaye H, et al. Cumulative live birth rates according to the number of oocytes retrieved after the first ovarian stimulation for in vitro fertilization/intracytoplasmic sperm injection: a multicenter multinational analysis including∼15,000 women. Fertil Steril. 2018;110(4):661-70.

Kawamura K, Cheng Y, Suzuki N, Deguchi M, Sato Y, Takae S, et al. Hippo signaling disruption and Akt stimulation of ovarian follicles for infertility treatment. Proceed Ntnl Acad Sci. 2013;110(43):17474-9.

Tanaka Y, Hsueh AJ, Kawamura K. Surgical approaches of drug-free in vitro activation and laparoscopic ovarian incision to treat patients with ovarian infertility. Fertil Steril. 2020;114(6):1355-7.

Kawamura K, Ishizuka B, Hsueh AJ. Drug-free in-vitro activation of follicles for infertility treatment in poor ovarian response patients with decreased ovarian reserve. Reproduct Biomed Online. 2020;40(2):245-53.

Lunding SA, Pors SE, Kristensen SG, Landersoe SK, Jeppesen JV, Flachs EM, et al. Biopsying, fragmentation and autotransplantation of fresh ovarian cortical tissue in infertile women with diminished ovarian reserve. Human Reproduct. 2019;34(10):1924-36.

Herraiz S, Romeu M, Buigues A, Martínez S, Díaz-García C, Gómez-Seguí I, et al. Autologous stem cell ovarian transplantation to increase reproductive potential in patients who are poor responders. Fertil Steril. 2018;110(3):496-505.

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;34(9):756-60.

Sfakianoudis K, Simopoulou M, Nitsos N, Rapani A, Pappas A, Pantou A, et al. Autologous platelet-rich plasma treatment enables pregnancy for a woman in premature menopause. J Clin Med. 2018;8(1):1.

Sfakianoudis K, Simopoulou M, Nitsos N, Rapani A, Pantou A, Vaxevanoglou T, et al. A case series on platelet-rich plasma revolutionary management of poor responder patients. Gynecol Obstetr Investigat. 2019;84(1):99-106.

Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: from basic science to clinical applications. Am J Sport Med. 2009;37(11):2259-72.

Shi W, Zhou H, Tian L, Zhao Z, Zhang W, Shi J. Cumulative live birth rates of good and low prognosis patients according to POSEIDON criteria: a single center analysis of 18,455 treatment cycles. Front Endocrinol. 2019;10:409.

Li Y, Li X, Yang X, Cai S, Lu G, Lin G, et al. Cumulative live birth rates in low prognosis patients according to the POSEIDON criteria: an analysis of 26,697 cycles of in vitro fertilization/intracytoplasmic sperm injection. Front Endocrinol. 2019;10:642.

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 Reproduct Genet. 2020;37(4):855-63.

Gunasheela D, Murali R, Appaneravanda LC, Gerstl B, Kumar A, Sengeetha N, et al. Age-specific distribution of serum anti-mullerian hormone and antral follicle count in Indian infertile women. Journal of Human Reproduct Sci. 2021;14(4):372.

Rosen MP, Johnstone E, Addauan-Andersen C, Cedars MI. A lower antral follicle count is associated with infertility. Fertil Steril. 2011;95(6):1950-4.

Crawford NM, Steiner AZ. Age-related infertility. Obstetr Gynecol Clinic. 2015;42(1):15-25.

Sharara FI, Lelea LL, Rahman S, Klebanoff JS, Moawad GN. A narrative review of platelet-rich plasma (PRP) in reproductive medicine. J Assist Reproduct Genet. 2021;38(5):1003-12.

Cakiroglu Y, Saltik A, Yuceturk A, Karaosmanoglu O, Kopuk SY, Scott RT, et al. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency. Aging (Albany NY). 2020;12(11):10211.

Tandulwadkar S, Karthick MS. Combined use of autologous bone marrow-derived stem cells and platelet-rich plasma for ovarian rejuvenation in poor responders. J Human Reproduct Sci. 2020;13(3):184.






Original Research Articles