Autologous platelet-rich plasma ovarian injection was associated with increased oocyte acquisition in patients with poor ovarian response: a retrospective propensity-matched study

BACKGROUND: Women with poor ovarian response (POR) tended to have lower success rates for IVF/ICSI due to fewer oocytes retrieved. Autologous platelet-rich plasma (PRP) has been proposed to improve ovarian response.

METHOD: This study aimed to evaluate the impact of autologous PRP ovarian injections on oocyte retrieval numbers and other reproductive outcomes in IVF/ICSI cycles among infertile women with POR, as defined by the Bologna criteria. Conducted at the Reproductive Center of the Sixth Affiliated Hospital of Sun Yat-sen University, this retrospective analysis involved a total of 1,833 oocyte retrieval cycles. Among these, 91 cycles involved patients who received autologous PRP injections, while 261 cycles were included in the control group after applying propensity score matching.

RESULTS: The PRP group showed a significant increase in the number of follicles ≥ 14 mm(2.96 ± 1.79 versus 2.26 ± 1.44, P < 0.001), retrieved oocytes(2.86 ± 1.88 versus 2.07 ± 1.78, P < 0.001), and normally fertilized zygotes(1.73 ± 1.42 versus 1.37 ± 1.44, P = 0.044) compared to the control group. Although the number of transferable embryos(1.34 ± 1.21 versus 1.07 ± 1.26, P = 0.079) and high-quality embryos(1.09 ± 1.16 versus 0.83 ± 1.13, P = 0.066) was higher in the PRP group, these differences were not statistically significant. Liner regression identified PRP injection(regression coefficient[B] 0.701, 95% confidence interval [CI] of B 0.324-1.079, P < 0.001), AMH levels(B 1.825, 95% CI of B 0.949-2.701, P < 0.001), and total gonadotropin dose( B < 0.001, 95% CI of B < 0.001-0.001, P = 0.004) as independent predictors for oocyte retrieval.

CONCLUSION: Autologous PRP ovarian injection was associated with an increased number of oocytes retrieved in patients with poor response; however, there was no significant improvement in embryo quality. Further randomized controlled trials are warranted to confirm these findings.