Live birth rates in poor responders’ group after previous treatment with autologous platelet-rich plasma and low dose ovarian stimulation compared with poor responders used only low dose ovarian stimulation before in vitro fertilization

BACKGROUND: This prospective pilot study determined the efficacy of previous transvaginal intraovarian injection with autologous platelet-rich plasma (PRP) in poor ovarian responders (PORs) fulfilling the Bologna criteria before in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) with low dose ovarian stimulation. Current knowledge of efficient treatment for PORs is limited and often contradictory; also, LBRs of IVF remains disappointingly low. AIM: We assessed the live birth rates (LBRs) in PORs after previous ovarian treatment with PRP. METHODS: Overall, 40 patients undergoing IVF/ICSI between June 2017 ending December 2018 were included. A transvaginal intraovarian injection of PRP was performed on 20 patients. Both compered groups were balanced for all basic characteristics, and multivariate analysis was performed to adjust for all known confounders. RESULTS: Between the groups, a statistical significance in clinical pregnancies and LBR was not found. Clinical pregnancy and live birth rates were 33.33 ± 44.99 and 40.00 ± 50.71 in the PRP group and 10.71 ± 28.95 and 14.29 ± 36.31 in control group retrospectively. However, there is a trend towards higher implantation rates and LBRs in patients with previous treatment with PRP. Anyhow, the number of patients used in the research is insufficient to make a concrete conclusion, and more studies are needed in the future to confirm these results entirely. CONCLUSION: Even though the treatment of POR responders remains as a therapeutical challenge, the usage of intraovarian injection of autologous PRP in PORs before the IVF performance brings a glimpse of new hope in increasing the success of IVF defined by clinical pregnancy and LBRs

Different Timing of Adjuvant Low Dose hCG and GnRH Agonist Trigger Protocol, in OHSS High-Risk Patient with Peak E2 Level <4000 pg/mL

Objective: The aim of the study is to compare the live birth rates between 1,500 I.U. of Human chorionic gonadotropin at the time of Gonadotropin-releasing hormone agonist trigger day or 35-36 h later on the oocyte pick-up day, without affecting the risk of significant ovarian hyperstimulation syndrome development in high-risk patients with peak E2 level <4,000 pg/m

Novel method of treating ovarian infertility: is Platelet-Rich Plasma a new promising therapy in the future?

Introduction. In today's modern society, the treatment of patients with poor ovarian reserve presents a medical challenge of increased clinical importance. The use of platelet-rich plasma (PRP) is a new hope that improves pregnancy chances. Increased use of the PRP in a number of in vitro centers around the world as well as publication of the first experience in in vitro fertilization entailed the need for this systematic review. Methods. PubMed, Cochrane and Ovid Medline were searched between 2000 and 2019 under the following strategy: [ and and ]. Fourteen original articles published in medical scientific journals were analyzed in this study. The evidence level and quality assessment were made based on the most up-to-date, reliable, scientific evidence as well as from the number of additional relevant citations. Results. Taking the current available proof and evidence into consideration, we can conclude that the PRP method improves the ovarian function and increases the chances of clinical pregnancy. In addition, we assume that, over time, the PRP method objectively improves the ovarian reserves. Recent studies support the theory of increasing the number of preantral follicles, followed by appropriate growth and reduction of follicular atresia. Conclusion. The improvement of the quantity and quality of oocytes with the intra-ovarian application of PRP potentially suggests a new concept of ovarian aging, where the ovarian microenvironment plays a crucial role