{"id":69326,"date":"2023-03-30T10:13:05","date_gmt":"2023-03-30T09:13:05","guid":{"rendered":"https:\/\/fertilityroad.com\/?p=69326"},"modified":"2025-05-05T18:13:31","modified_gmt":"2025-05-05T17:13:31","slug":"ivf-prp-platelet-rich-plasma-ovarian-reactivation-rejuvenation","status":"publish","type":"post","link":"https:\/\/fertilityroad.com\/nl\/mag\/ivf-prp-platelet-rich-plasma-ovarian-reactivation-rejuvenation\/","title":{"rendered":"PRP, platelet-rich plasma, a technique for ovarian reactivation (rejuvenation)"},"content":{"rendered":"
The prognosis of patients under the age of 40 who undergo PRP can be improved. It is important to note that the aim is to increase the number of eggs because the technique does not increase the quality of the eggs.<\/p>\n\n\n\n
Dr. Ana Fuentes, head of the Low Ovarian Reserve Unit at the Bernabeu Institute, explains that PRP is a treatment with which the clinic has already had a year and a half’s experience treating patients with a low response. “We indicate it if we think it can improve their prognosis and if there are no contraindications.<\/p>\n\n\n\n
The doctor warns that up to 20% of the cycles may have a low response, and it is a part of them to whom PRP is administered, not all of them. It is part of the complementary treatments along with other low-response strategies.<\/p>\n\n\n\n
The technique “awakens” dormant follicles and makes it possible to obtain eggs that cannot be obtained with conventional ovarian stimulation.<\/p>\n\n\n\n
In patients over 40 years of age, experts do not recommend PRP, warning that it is not advisable. This is because, from the age of 40 onwards, more oocytes are needed to improve the prognosis. It is important to note that in women over 40, the quality of the eggs obtained is not improved because the oocytes correspond to the patient’s age. <\/p>\n\n\n\n
On the other hand, for a woman of around 35 years of age, the difference between obtaining 2 more oocytes is very important and can change the outcome of the treatment.<\/p>\n\n\n\n
The fame that PRP has acquired means that some patients want to have this treatment but have no need for activation. “There are patients who want PRP without needing it,” explains Dr. Fuentes.<\/p>\n\n\n\n
\nPRP is a treatment that is performed in conjunction with other strategies. It is also being applied in cases of ovarian failure, to see if in these very specific cases it is possible to activate follicles. It is a treatment that has hardly any contraindications and is simple.<\/p>\n<\/blockquote>\n\n\n\n
IVF PRP success stories<\/h2>\n\n\n\n
No relevant medical history, a 33-year-old female<\/h3>\n\n\n\n
A 33-year-old female patient with no relevant history<\/strong> comes to us interested in the vitrification of oocytes for preservation. She has no partner.<\/p>\n\n\n\n
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- The study shows low ovarian reserve markers. Antim\u00fcllerian hormone (AMH) 0.4 ngml (normal 1 ng\/ml). Antral follicle count (AFR): 3+2.<\/li>\n\n\n\n
- Ovarian stimulation is performed with 300 ui of recombinant FSH: growth of two follicles, a mature oocyte is obtained which is vitrified. Intraovarian PRP is administered on the day of the puncture.<\/li>\n\n\n\n
- New stimulation is performed in the second post-PRP cycle with the same protocol: 4 follicles grow and 4 oocytes are obtained.<\/li>\n<\/ul>\n\n\n\n
Female 40 years old with a 43-year-old partner<\/h3>\n\n\n\n
Female 40 years old and male 43 years old. Looking for pregnancy for two years and IVF failure due to low ovarian response.<\/strong><\/p>\n\n\n\n
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- Male normal sperm analysis.<\/li>\n\n\n\n
- Female: AMH 0.5 ng\/ml. Low antral follicle count: 2+1. Previous response to ovarian stimulation: 1st response of a single follicle reconverts to insemination. 2nd 3 oocytes, transfer of an embryo on day 3, no pregnancy.<\/li>\n\n\n\n
- Ovarian stimulation is performed in our clinic: administration of androgens in the previous cycle, and stimulation with recombinant FSH and hMG, in antagonist protocol. Growth of two follicles. Two mature oocytes are obtained and an embryo is obtained on day 5, which undergoes an embryo biopsy, resulting in a non-transferable aneuploid embryo.<\/li>\n\n\n\n
- After oocyte retrieval, intraovarian PRP is administered.<\/li>\n\n\n\n
- A new stimulation similar to the previous one is performed without previous androgens in the cycle after PRP: 5 mature oocytes are obtained and 3 embryos are obtained on day 5. After the biopsy, none of them are genetically normal for transfer.<\/li>\n\n\n\n
- A double stimulation cycle is performed (2 cycles after PRP): obtaining 7 and 6 mature oocytes, resulting in 7 embryos on day 5: they are biopsied and none of them is genetically normal.<\/li>\n<\/ul>\n\n\n\n
This case shows an improvement in the quantity of oocytes<\/strong> without improving the quality but allowed us to analyse a greater number of embryos.<\/p>\n\n\n\n
The couple – 39 years old woman and her 45 years old partner<\/h3>\n\n\n\n
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- Normal sperm analysis.<\/li>\n\n\n\n
- They have been looking for pregnancy for 3 years.<\/li>\n\n\n\n
- She has very low ovarian reserve markers with the absence of menstruation for some months (signs of ovarian failure). AMH 0.02 ng and RFA: 0.<\/li>\n\n\n\n
- The history of previous stimulation cancelled due to non-response in another clinic.<\/li>\n\n\n\n
- She wanted to try a new stimulation and intraovarian PRP was administered prior to stimulation.<\/li>\n\n\n\n
- After a post-PRP cycle, gentle stimulation is performed with 150 IU of FSH and two follicles grow, two oocytes are obtained, one mature oocyte which is vitrified. <\/li>\n\n\n\n
- A second stimulation is performed and a follicle grows. Another mature oocyte is obtained. <\/li>\n\n\n\n
- Both oocytes fertilise resulting in two embryos, pending transfer.<\/strong><\/li>\n<\/ul>\n\n\n\n
In general, we have observed (preliminary data) improvement in response, between 1-2 more oocytes in post-PRP cycles, mainly in patients younger than 40. In patients over 40 the prognosis does not improve because many more oocytes are needed. We must still be cautious with these results.<\/p>\n\n\n\n
Use of platelet-rich plasma (PRP) in low ovarian reserve<\/h2>\n\n\n\n
Low ovarian reserve means a lower probability of spontaneous conceiving, as well as a decrease in the number of eggs obtained in ovarian stimulation treatments. At Bernabeu Instituut<\/a>, the low ovarian reserve unit works to develop individualized stimulation protocols for this type of patient, together with pharmacogenetic studies (which determine the most appropriate medication according to the genes involved in ovarian response) and technological advances in the laboratory, which make it possible to accumulate eggs in several cycles of stimulation.<\/p>\n\n\n\n