INNOVATIVE TECHNOLOGIES IN REPRODUCTIVE MEDICINE: PLATELET-RICH PLASMA FOR OVARIAN REJUVENATION AND INFERTILITY - A NARRATIVE REVIEW

and purpose: Regenerative medicine has introduced new biological strategies to improve ovarian function in women with diminished ovarian reserve (DOR) or premature ovarian insufficiency (POI). Among them, platelet-rich plasma (PRP) - a concentrate of platelets derived from the patient’s own blood - has gained interest for its potential to stimulate follicular growth and enhance reproductive capacity. PRP contains various growth factors and cytokines that promote angiogenesis, cell proliferation, and tissue repair. This review summarizes current evidence regarding PRP’s mechanisms of action, clinical effects, and safety in the context of ovarian rejuvenation. State of knowledge: PRP is obtained by centrifuging autologous blood to increase platelet concentration, followed by activation using agents such as calcium chloride or thrombin. Once activated, platelets release growth factors including PDGF, VEGF, EGF, IGF, and TGF-β, which are involved in tissue regeneration and modulation of inflammation. When injected into the ovaries, PRP may stimulate dormant follicles, improve blood flow, and alter the ovarian microenvironment via anti-inflammatory and immunomodulatory effects. Early clinical studies report encouraging outcomes such as improved ovarian reserve markers and pregnancy rates.

PRP therapy is a promising, minimally invasive technique with potential to support ovarian function in selected patients with POI or DOR. Its use is biologically justified by the regenerative properties of platelet-derived factors. Nevertheless, due to limited and low-quality evidence, as well as a lack of standardized preparation and administration protocols, PRP cannot yet be recommended as routine treatment.

Vali, S., Saso, S., Bracewell Milnes, T., Nicopoullos, J., Thum, M. Y., Smith, J. R., & Jones, B. P. (2023). The clinical application of platelet-rich plasma in the female reproductive system: A narrative review. Life, 13(12), 2348. https://doi.org/10.3390/life13122348 Gupta, S., Paliczak, A., & Delgado, D. (2021). Evidence-based indications of platelet-rich plasma therapy. Expert Review of Hematology, 14(1), 97–108. https://doi.org/10.1080/17474086.2021.1860002 Streit-Ciećkiewicz, D., Kołodyńska, A., Futyma-Gąbka, K., Grzybowska, M. E., Gołacki, J., & Futyma, K. (2022). Platelet rich plasma in gynecology—Discovering undiscovered: Review. International Journal of Environmental Research and Public Health, 19(9), 5284. https://doi.org/10.3390/ijerph19095284 Collins, T., Alexander, D., & Barkatali, B. (2021). Platelet-rich plasma: A narrative review. EFORT Open Reviews, 6(4), 225–235. https://doi.org/10.1302/2058-5241.6.200017 Marx, R. E. (2001). Platelet-rich plasma (PRP): What is PRP and what is not PRP? Implant Dentistry, 10(4), 225–228. https://doi.org/10.1097/00008505-200110040-00002 Pachito, D. V., Bagattini, Â. M., de Almeida, A. M., Mendrone-Júnior, A., & Riera, R. (2020). Technical procedures for preparation and administration of platelet-rich plasma and related products: A scoping review. Frontiers in Cell and Developmental Biology, 8, 598816. https://doi.org/10.3389/fcell.2020.598816 Amable, P. R., Carias, R. B., Teixeira, M. V., da Cruz Pacheco, I., Corrêa do Amaral, R. J., Granjeiro, J. M., & Borojevic, R. (2013). Platelet-rich plasma preparation for regenerative medicine: Optimization and quantification of cytokines and growth factors. Stem Cell Research & Therapy, 4(3), 67. https://doi.org/10.1186/scrt218 Everts, P. A., Lana, J. F., Alexander, R. W., Dallo, I., Kon, E., Ambach, M. A., van Zundert, A., & Podesta, L. (2024). Profound properties of protein-rich, platelet-rich plasma matrices as novel, multi-purpose biological platforms in tissue repair, regeneration, and wound healing. International Journal of Molecular Sciences, 25(14), 7914. https://doi.org/10.3390/ijms25147914 Ziegler, C. G., Van Sloun, R., Gonzalez, S., Whitney, K. E., DePhillipo, N. N., Kennedy, M. I., Dornan, G. J., Evans, T. A., Huard, J., & LaPrade, R. F. (2019). Characterization of growth factors, cytokines, and chemokines in bone marrow concentrate and platelet-rich plasma: A prospective analysis. American Journal of Sports Medicine, 47(9), 2174–2187. https://doi.org/10.1177/0363546519832003 Serdarogullari, M., Raad, G., Makieva, S., Liperis, G., Fraire-Zamora, J. J., & Celik-Ozenci, C. (2024). Revitalizing female fertility: Platelet-rich plasma—Hype or hope? Reproductive Biomedicine Online, 49(2), 103813. https://doi.org/10.1016/j.rbmo.2024.103813 Rickers, N. S., & Sills, E. S. (2022). Is autologous platelet activation the key step in ovarian therapy for fertility recovery and menopause reversal? Biomedicine, 12(4), 1–8. https://doi.org/10.37796/2211-8039.1380 Cengiz, I. F., Oliveira, J. M., & Reis, R. L. (2018). PRP therapy. In Advances in Experimental Medicine and Biology (Vol. 1059, pp. 241–253). Springer. https://doi.org/10.1007/978-3-319-76735-2_11 Everts, P., Onishi, K., Jayaram, P., Lana, J. F., & Mautner, K. (2020). Platelet-rich plasma: New performance understandings and therapeutic considerations in 2020. International Journal of Molecular Sciences, 21(20), 7794. https://doi.org/10.3390/ijms21207794 Cox, C. M., Thoma, M. E., Tchangalova, N., Mburu, G., Bornstein, M. J., Johnson, C. L., & Kiarie, J. (2022). Infertility prevalence and the methods of estimation from 1990 to 2021: A systematic review and meta-analysis. Human Reproduction Open, 2022(4), hoac051. https://doi.org/10.1093/hropen/hoac051 Pastore, L. M., Christianson, M. S., Stelling, J., Kearns, W. G., & Segars, J. H. (2018). Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR. Journal of Assisted Reproduction and Genetics, 35(1), 17–23. https://doi.org/10.1007/s10815-017-1058-4 Ishizuka, B. (2021). Current understanding of the etiology, symptomatology, and treatment options in premature ovarian insufficiency (POI). Frontiers in Endocrinology, 12, 626924. https://doi.org/10.3389/fendo.2021.626924 Drakopoulos, P., Bardhi, E., Boudry, L., Vaiarelli, A., Makrigiannakis, A., Esteves, S. C., Tournaye, H., & Blockeel, C. (2020). Update on the management of poor ovarian response in IVF: The shift from Bologna criteria to the Poseidon concept. Therapeutic Advances in Reproductive Health, 14, 2633494120941480. https://doi.org/10.1177/2633494120941480 Moustaki, M., Kontogeorgi, A., Tsangkalova, G., Tzoupis, H., Makrigiannakis, A., Vryonidou, A., & Kalantaridou, S. N. (2023). Biological therapies for premature ovarian insufficiency: What is the evidence? Frontiers in Reproductive Health, 5, 1194575. https://doi.org/10.3389/frph.2023.1194575 Éliás, M., Kónya, M., Kekk, Z., Turan, C., das Virgens, I. P. A., Tóth, R., Keszthelyi, M., Hegyi, P., Várbíró, S., & Sipos, M. (2024). Platelet-rich plasma (PRP) treatment of the ovaries significantly improves fertility parameters and reproductive outcomes in diminished ovarian reserve patients: A systematic review and meta-analysis. Journal of Ovarian Research, 17(1), 104. https://doi.org/10.1186/s13048-024-01423-2 Zhu, Q., Li, Y., Ma, J., Ma, H., & Liang, X. (2023). Potential factors resulting in diminished ovarian reserve: A comprehensive review. Journal of Ovarian Research, 16(1), 208. https://doi.org/10.1186/s13048-023-01296-x Molinaro, P., Ballester, A., Garcia-Velasco, J. A., Muñoz, M., & Herraiz, S. (2025). Impact of bilateral intraovarian platelet-rich plasma in women with poor ovarian response or primary ovarian insufficiency: A retrospective study. Fertility and Sterility. Advance online publication. https://doi.org/10.1016/j.fertnstert.2025.05.143 Sadeghpour, S., Maleki, F., Hajizadeh-Sharafabad, F., & Ghasemnejad-Berenji, H. (2025). Evaluation of intraovarian injection of platelet-rich plasma for enhanced ovarian function and reproductive success in women with POI and POR: A systematic review and meta-analysis. European Journal of Medical Research, 30(1), 610. https://doi.org/10.1186/s40001-025-02854-3 Pantos, K., Simopoulou, M., Pantou, A., Rapani, A., Tsioulou, P., Nitsos, N., Syrkos, S., Pappas, A., Koutsilieris, M., & Sfakianoudis, K. (2019). A case series on natural conceptions resulting in ongoing pregnancies in menopausal and prematurely menopausal women following platelet-rich plasma treatment. Cell Transplantation, 28(9–10), 1333–1340. https://doi.org/10.1177/0963689719859539 Sfakianoudis, K., Simopoulou, M., Nitsos, N., Rapani, A., Pappas, A., Pantou, A., Chronopoulou, M., Deligeoroglou, E., Koutsilieris, M., & Pantos, K. (2018). Autologous platelet-rich plasma treatment enables pregnancy for a woman in premature menopause. Journal of Clinical Medicine, 8(1), 1. https://doi.org/10.3390/jcm8010001 Ferrari, A. R., Cortrezzi, S., Borges, E., Jr., Braga, D., Souza, M. D. C. B., & Antunes, R. A. (2021). Evaluation of the effects of platelet-rich plasma on follicular and endometrial growth: A literature review. JBRA Assisted Reproduction, 25(4), 601–607. https://doi.org/10.5935/1518-0557.20210036 Wang, X., Li, J., Lu, W., Gao, F., Zhang, S., & Li, J. (2024). Therapeutic roles of platelet-rich plasma to restore female reproductive and endocrine dysfunction. Frontiers in Endocrinology, 15, 1374382. https://doi.org/10.3389/fendo.2024.1374382 Hajipour, H., Farzadi, L., Latifi, Z., Keyhanvar, N., Navali, N., Fattahi, A., Nouri, M., & Dittrich, R. (2021). An update on platelet-rich plasma (PRP) therapy in endometrium and ovary related infertilities: Clinical and molecular aspects. Systems Biology in Reproductive Medicine, 67(3), 177–188. https://doi.org/10.1080/19396368.2020.1862357 Liu, X., Shen, M., Qi, Q., Zhang, H., & Guo, S. W. (2016). Corroborating evidence for platelet-induced epithelial–mesenchymal transition and fibroblast-to-myofibroblast transdifferentiation in the development of adenomyosis. Human Reproduction, 31(4), 734–749. https://doi.org/10.1093/humrep/dew018 Burnouf, T., Chou, M. L., Lundy, D. J., Chuang, E. Y., Tseng, C. L., & Goubran, H. (2023). Expanding applications of allogeneic platelets, platelet lysates, and platelet extracellular vesicles in cell therapy, regenerative medicine, and targeted drug delivery. Journal of Biomedical Science, 30(1), 79. https://doi.org/10.1186/s12929-023-00972-w Stellos, K., Kopf, S., Paul, A., Marquardt, J. U., Gawaz, M., Huard, J., & Langer, H. F. (2010). Platelets in regeneration. Seminars in Thrombosis and Hemostasis, 36(2), 175–184. https://doi.org/10.1055/s-0030-1251502 Garavelas, A., Mallis, P., Michalopoulos, E., & Nikitos, E. (2023). Clinical benefit of autologous platelet-rich plasma infusion in ovarian function rejuvenation: Evidence from a before–after prospective pilot study. Medicines, 10(3), 19. https://doi.org/10.3390/medicines10030019 Melo, P., Navarro, C., Jones, C., Coward, K., & Coleman, L. (2020). The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: A non-randomized interventional study. Journal of Assisted Reproduction and Genetics, 37(4), 855–863. https://doi.org/10.1007/s10815-020-01710-z Li, Q., Guo, J. Y., Liu, J. W., Li, J., Zou, L. N., Fang, C., & Liang, X. (2025). Comparative efficacy of single vs. double autologous platelet-rich plasma ovarian injections for improving ovarian response in poor ovarian responders. Scientific Reports, 15(1), 18292. https://doi.org/10.1038/s41598-025-02689-2 Vaidakis, D., Papapanou, M., & Siristatidis, C. S. (2024). Autologous platelet-rich plasma for assisted reproduction. Cochrane Database of Systematic Reviews, 2024(4), CD013875. https://doi.org/10.1002/14651858.CD013875.pub2 Sfakianoudis, K., Simopoulou, M., Grigoriadis, S., Pantou, A., Tsioulou, P., Maziotis, E., Rapani, A., Giannelou, P., Nitsos, N., Kokkali, G., Koutsilieris, M., & Pantos, K. (2020). Reactivating ovarian function through autologous platelet-rich plasma intraovarian infusion: Pilot data on premature ovarian insufficiency, perimenopausal, menopausal, and poor responder women. Journal of Clinical Medicine, 9(6), 1809. https://doi.org/10.3390/jcm9061809 Dawood, A. S., & Salem, H. A. (2018). Current clinical applications of platelet-rich plasma in various gynecological disorders: An appraisal of theory and practice. Clinical and Experimental Reproductive Medicine, 45(2), 67–74. https://doi.org/10.5653/cerm.2018.45.2.67 Downloads Published Issue Section License All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles. CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.