P-574 Ovarian Revitalisation using Platelet Rich Plasma

Abstract Study question Can we rejuvinate ovaries (with low ovarian reserve) by injecting fresh platelet rich plasma ? Summary answer With ovarian PRP injections, Ovarian reserve will increase and number of follicles increases in treated ovaries . What is known already Till date no definitive treatment is available to restore function of ovaries. Few drugs e.g. granulocyte colony stimulating factor etc tried for the same but no satisfactory result was achieved. Oral ovulogens and gonadotropins cannot produce satisfactory number of ova in these patients. So they were forced to go for donar ova. By using ovarian PRP injections couple can have a chance of their own biological child. Study design, size, duration we conducted the pilot study involving injection of autologous fresh platelet rich plasma injection into the ovaries of subfertile females by comparison of their fertility parameters viz. hormonal profile involving measurements of blood levels of follicular stimulating hormone (FSH), luteinizing hormone (LH), anti-Mullerian hormone (AMH), prostaglandin E2 levels (PGE2); antral follicular count (AFC); number of mature follicles (NMF) and number of retrieved oocytes (NRO) in both pre-PRP and post-PRP states. Participants/materials, setting, methods Forty-five subfertile females of more than 20 years were included in our study . All the patients underwent fresh autologous PRP injection under transvaginal ultrasonographic guidance. Besides the demographic data, each patient’s hormonal profile (including blood levels of AMH, FSH, LH, PGE2), AFC, NMF and NRO in both pre-PRP and post-PRP state were recorded in a predesigned proforma. Statistical evaluation of the recorded data was done using appropriate methods and tools. Main results and the role of chance Mean age, weight, height, body mass index and years of subfertility of the patients in our study was 31.27yrs, 58.38kg, 154.84cm, 24.37kg/m2 and 8.44years respectively. The mean blood levels of AMH increased significantly in post-PRP state (1.6 vs 2.4pg/ml) in contrast to significant decrease in blood level of FSH (21.4 vs 12.5mIU/ml), LH (15.1 vs 5.9mIU/ml) & PGE2 (162.7 vs 66pg/ml). The AFC, NMF & NRO also increased in post-PRP state relative to pre-PRP state. The differences in above levels and numbers were statistically significant. Limitations, reasons for caution Autologous PRP injection into ovaries improves hormonal profile, AFC and number of mature follicles as well as retrieved oocytes. Furthur followup is needed to know weather our patients concieve spontaneously or they will need some kind of assisted tecniques to concieve a pregnency. Wider implications of the findings Autologous PRP injection into ovaries improves hormonal profile, AFC and number of mature follicles as well as retrieved oocytes, it can be utilized as a revitalisation tool to boost fertility. Our study results reinforce the above concept. However, outcome-based studies are needed to further validate the results of our study. Trial registration number TMU/IEC/19-20/0113