A report on three live births in women with poor ovarian response following intra-ovarian injection of platelet-rich plasma (PRP).

The prevalence of poor response to gonadotropin stimulation is approximately 9-24% in women undergoing in vitro fertilization. Interestingly, due to containing a variety of growth factors, platelet-rich plasma (PRP) can play an important role in tissue regeneration and healing. Thus, in this research, we aimed to investigate the intra-ovarian injection of PRP in women with poor ovarian response. To this goal, 23 poor responders constituted the study population, from among whom 19 women were enrolled. These patients underwent ovarian stimulation according to the Shanghai protocol. Immediately after the first follicular puncture, 2 mL of PRP was injected into each ovary. 1 day after the first puncture and PRP injection, the second stimulation was initiated. Then, oocyte retrieval was followed. About 2-3 months after the first cycle, the patients underwent another treatment with ovarian stimulation according to the Shanghai protocol and then, follicular puncture was performed. The mean numbers of oocytes before and after PRP injection were 0.64 and 2.1, respectively. Two patients experienced spontaneous conceptions. The third case achieved clinical pregnancy and delivered a healthy baby in June 2018. The results of this study appeared to be the first report on the effects of intra-ovarian PRP injection on the increase of ovarian responses, even on the spontaneous conceptions of women with poor ovarian response.

Successful pregnancy and live birth after intrauterine administration of autologous platelet-rich plasma in a woman with recurrent implantation failure: A case report.

BACKGROUND: Platelets contain a significant amount of growth factors that have positive effects on local tissue repair and endometrial receptivity. CASE: Here we present a 45-yr-old woman with primary infertility and two failed in vitro fertilization (IVF) cycles who was candidate to receive donor eggs. Five consecutive frozen-thawed embryo transfer cycles with good quality embryos were performed within 2 yr. With the diagnosis of recurrent implantation failure (RIF), the patient was treated for improving endometrial receptivity with intrauterine administration of autologous platelet-rich plasma (PRP), 24 hr before embryo transfer. The patient gave birth to a healthy baby boy weighing 2350 gr in the cesarean section. CONCLUSION: Extensive literature search suggests that this is the first successful pregnancy after administration of PRP in a woman with RIF. Local administration of PRP before embryo transfer may play a vital role in successful implantation .

A New Approach Using Autologous Platelet-Rich Plasma (PRP) to Treat Infertility and To Improve Population Replacement Rate.

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Is reducing ovarian volume in polycystic ovarian syndrome patients after administration of metformin associated with improving cardiovascular risk factors?

BACKGROUND: Women with polycystic ovary syndrome (PCOS) are at increased risk for cardiovascular (CV) and metabolic disorders. There is a close relationship between elevated androgen plasma levels and the ultrasound findings of stromal hypertrophy. In randomized trials, the administration of metformin has been shown to be followed by an improvement in insulin sensitivity and decrease in androgen levels in most women. In the present study, we investigate the association between reduced ovarian volume in PCOS patients after administration of metformin with improvement in CV risk factors. MATERIALS AND METHODS: This was a randomized clinical trial study. A total of 28 women diagnosed with PCOS who referred to the infertility clinic were selected. Anthropometric characteristics of the patients, mean ovarian volume and plasma levels of fasting blood sugar (FBS), lipid profile, luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, testosterone, 17-α-OH progesterone (17OHP), dehydroepiandrosterone sulfate (DHEAS), C-reactive protein (CRP) and homocysteine (Hcy) were evaluated before and after treatment with 500 mg metformin, three times daily for three months. Statistics were calculated with the aid of SPSS 16.0 with student's paired t- and Pearson's correlation coefficient tests. Significance was set at p<0.05. RESULTS: There were significant reductions in mean ovarian volume and body mass index (BMI), in addition to CRP, Hcy, testosterone, FBS, HDL and LDL levels. There was a positive correlation between mean ovarian volume and waist-to-hip ratio (WHR).After treatment, there correlation noted with reduction in mean ovarian volume and decreased BMI, in addition to reductions in CRP, LDL, Hcy and testosterone levels. CONCLUSION: A positive correlation may exist between reduced mean ovarian volume and improvement in cv risk factors after administration of metformin ( REGISTRATION NUMBER: IRCT138903244176N1).