P-798 Comprehensive evaluation of autologous Platelet-Rich Plasma infusion in ovarian rejuvenation
Authors: Garavellas A , Mallis P , Michalopoulos E , Nikitos E 
Published: June 2023

Abstract

Study question
This study aimed to the evaluation of PRP injection in women with ovarian dysfunction (with POR, POI, perimenopause and menopause) to promote the ovarian rejuvenation.

Summary answer
Intraovarian infusion of autologous PRP exhibited remarkable evidence and promising results to restore ovarian insufficiency.

What is known already
Ovarian dysfunctions, such as premature ovarian insufficiency (POI) and poor ovarian response (POR) are conditions, characterized by the collapse of ovarian function and are considered currently as a global public health issue. Primary factors that are associated with female infertility include endocrine dysfunction, failure of embryo implantation, endometriosis, and other related pathologies such as polycystic ovary syndrome (PCOS), various environmental factors and inflammatory disease. For this purpose, the rejuvenation of the ovaries using the intraovarian PRP injections may result in increased release of follicles from the available reservoir, and can potentially increase the possibility of a successful pregnancy.

Study design, size, duration
This study was designed as a randomized prospective observational pilot study. A number of 582 participants were interested to participate. The whole study was performed between May 2018 and December 2021. The patients were subdivided into 5 groups, followeeed by autologous blood collection, PRP preparation and intraovarian injection. The follow-up of the patients lasted for 2 months.

Participants/materials, setting, methods
The classification of the participants was performed into the following groups: Group A (22-38 years), Group B (39-44 years), Group C (45-57 years), Group D (48-50 years) and Group E (51-56 years). 60 ml of autologous blood was collected from each patient, followed by the preparation of PRP. Intraovarian PRP injection was performed and monitoring of the ovarian function including the quantification of FSH, LH, AMH and E2 for two constitutive menstrual cycles, was performed.

Main results and the role of chance
For group A, decrease of more than 50% was detected for the FSH and LH whereas, the levels of E2 and AMH were elevated by more than 44% and 31%, respectively in all participants Moreover, statistically significant differences regarding the levels of FSH (p = 0.001), LH (p = 0.046) , E2 (p = 0.035) and AMH (p = 0.012), were observed after the 1st and 2nd month of follow-up. In group B, a statistically significant decrease in FSH (p &lt; 0.001) and LH (p = 0.001) levels were observed in all participants. In parallel, the elevation of E2 and AMH levels was observed. Moreover, 28% of the participants with diagnosed POI, after the PRP infusion, achieved successful pregnancies and live births. In group C, after the PRP infusion, a reduction in FSH and LH levels with a parallel increase of E2 and AMH levels was detected. In group D, the levels of FSH and LH slightly declined after the PRP infusion. Also, the levels of E2 and AMH were increased. In group E, the levels of FSH and LH declin

Limitations, reasons for caution
No classifications between responders and no responders after the PRP administration were performed. Additionally, no presence of control groups in each category nor the determination of the growth factor content of the produced PRP was performed. The relatively limited time for the follow-up can also be considered a further limitation.

Wider implications of the findings
The administration of autologous PRP can be considered a safe and tolerable alternative approach to the classical ones for ovarian rejuvenation. This in turn could result to better conceiving rates, thus may beneficially improve the social impact of women with ovarian dysfunction.

Trial registration number
10/10/19