Intra-Ovarian Platelet-Rich Plasma in POSEIDON Group IV Poor Responders: A Pilot Study on ICSI Outcomes | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 27, Volume 100, Issue 1, July 2025, Page 2707-2712 PDF (605.95 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.436796 | ||||
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| Abstract | ||||
| Background: Women classified as POSEIDON group IV poor responders face significant challenges with assisted reproductive technology (ART) because they produce few oocytes and have lower pregnancy rates. Researchers are investigating intra-ovarian injection of platelet-rich plasma (PRP) as a promising method to enhance their ovarian response to treatment. Objective: This study aimed to evaluate the effectiveness of intraovarian platelet-rich plasma (PRP) injection in improving laboratory outcomes and pregnancy rates in POSEIDON Group IV poor ovarian responders undergoing intracytoplasmic sperm injection (ICSI). Patients and Methods: This pilot study involved 55 women categorized as POSEIDON group IV poor responders. The PRP group (n=25) received intra-ovarian PRP injections (3ml per ovary, prepared by buffy coat protocol) post-menstrually, one cycle prior to ICSI, in combination with gonadotropins. A control group (n=30) comprised women who declined PRP. Both groups subsequently underwent a GnRH antagonist ICSI protocol. Results: While baseline demographics were similar, the PRP group exhibited a significantly longer duration of infertility (median 7.7 vs 4.0 years, p=0.026) and lower baseline E2 levels (median 26.8 vs 41.0 pg/ml, p=0.010). However, despite these differences and the use of PRP, there were no statistically significant variations between the PRP and control groups in key reproductive outcomes, including the number of retrieved oocytes (median 5 vs 6), fertilized oocytes (median 3 vs 2), transferred embryos (median 2 vs 1.5), hormonal levels on trigger day, endometrial thickness, or, crucially, the ongoing pregnancy rate (32.0% in PRP vs 16.7% in control, p=0.183). Other pregnancy outcomes and adverse events were also comparable between the groups. Conclusion: It could be concluded that intra-ovarian PRP injection prior to ICSI does not demonstrate a statistically significant improvement in ovarian response parameters or pregnancy outcomes for POSEIDON group IV poor responders. Larger, randomized controlled trials are needed to further investigate its potential efficacy. | ||||
| Keywords | ||||
| Platelet-Rich Plasma; Poor Ovarian Responders; Ovarian Rejuvenation; Infertility | ||||
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