i40 39th Hybrid Annual Meeting of the ESHRE, Copenhagen – Denmark, 25-28 June 2023

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.. SELECTED ORAL COMMUNICATIONS
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.. SESSION 22: NEW CONCEPTS: POOR RESPONDERS
.. Monday 26 June 2023 Hall D3 15:15 - 16:30
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.. Abstract citation ID: dead093.079
.. O-065 A multi-center randomized controlled trial of intraovarian
.. injection of platelet rich plasma for women with poor ovarian
..
.. response
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.. N. Herlihy1, Y. Cakiroglu2, C. Whitehead1, A. Reig1, A. Klimczak1,
.. R. Scott1, B. Tiras2, E. Seli1
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.. 1
IVIRMA New Jersey, Reproductive Endocrinology and Infertility, Basking Ridge,
.. U.S.A.
.. 2
.. Acibadem Mehmet Ali Aydinlar University, Obstetrics and Gynecology, Istanbul,
.. Turkey
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.. Study question: Does intraovarian injection of autologous platelet-rich
.. plasma (PRP) improve oocyte yield in young patients with poor ovarian re-
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.. sponse (POR)?
.. Summary answer: Intra-ovarian PRP injection did not result in increased
.. number of oocytes retrieved or improvement of any other relevant measured
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.. outcomes.
.. What is known already: POR is one of the major hurdles to overcome in
.. patients undergoing controlled ovarian hyperstimulation (COH) for in vitro
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.. fertilization (IVF). Several methods have recently emerged to attempt follicular
.. reactivation in these patients with a poor prognosis. One of them, the intra-
.. ovarian injection of autologous PRP, demonstrated promising results in retro-
.. spective and prospective cohort studies.
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.. Study design, size, duration: This was a multi-center, randomized con-
.. trolled trial (RCT) to evaluate the efficacy of PRP in improving IVF outcomes
.. in women with POR. Patients who met inclusion criteria (<38 years, two or
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.. more prior cycles with < 3 oocytes retrieved, and without single gene disor-
.. ders, prior ovarian surgery, endometriomas, BMI >35, or severe male factor
.. infertility) were randomized to either receive an autologous intra-ovarian PRP
.. injection (PRP group) or no intervention (control group) prior to COH.
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.. Participants/materials, setting, methods: A total of 83 patients were
.. randomized to PRP group (n ¼ 41) or control group (n ¼ 42). After treat-
.. ment, patients underwent COH, oocyte retrieval, intracytoplasmic sperm
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.. injection (ICSI), preimplantation genetic testing for aneuploidy (PGT-A), and
.. single frozen euploid embryo transfer. Number of MII oocytes obtained was
.. the primary outcome. Secondary outcomes included ovarian reserve tests
.. (antral follicle count [AFC] and anti-Mullerian hormone [AMH]), blastocyst
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.. and euploid blastocyst yields, and sustained implantation.
.. Main results and the role of chance: No significant differences were ob-
.. served in number of MII oocytes retrieved (3.1 § 3.3 vs 2.8 § 2.4 in PRP
.. vs control, respectively; p ¼ 0.9), blastocysts (1.3 § 2.1 vs 1.0 § 1.3,
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.. p ¼ 0.8), or euploid blastocysts (0.9 § 1.6 vs 0.8 § 1.1; p ¼ 0.5) per cycle.
.. Similarly, no differences were observed in the likelihood of obtaining at least
.. one euploid blastocyst (37 vs 45%, p ¼ 0.4; relative risk [RR], 95% confidence
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.. interval [CI] 0.9, 0.6-1.2) or the rate of sustained implantation (29 vs 31%,
.. p ¼ 0.9; RR 1.0, 0.7-1.3). Pre- and post-treatment AFC in both groups (PRP:
.. from 5.2 § 3.2 to 7.9 § 4.5, p < 0.0001; control: from 5.6 § 3.3 to 6.8
.. § 4.8, p ¼ 0.02) were statistically significantly different, whereas AMH was
39th Hybrid Annual Meeting of the ESHRE, Copenhagen – Denmark, 25-28 June 2023 i41

different in the PRP group only (PRP: 0.73 § 0.46 to 0.99 § 0.98, p ¼ 0.02; ..
control: 0.70 § 0.59 to 0.73 § 0.57, p ¼ 0.59).
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Limitations, reasons for caution: Oocyte retrieval took place the cycle ..
immediately following treatment; therefore, we could not evaluate long-term ..
effects of PRP on ovarian reserve or response. Lack of a placebo group would
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limit interpretability had a difference between groups been observed. The ef- ..
fect of PRP on patients >38 years old was not studied. ..
Wider implications of the findings: Intra-ovarian PRP injection did not
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..
improve reproductive outcomes by any relevant measure. Our findings do ..
not support wide utilization of PRP to improve IVF outcomes in women with ..
POR. ..

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Trial registration number: NCT04163640 ..
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