Spontaneous pregnancy following intra-ovarian platelet-rich plasma administration in poor ovarian responders according to the POSEIDON criteria: A cross-sectional study

Marzie Sanuie Farimani, Kimia Amiri, Roghayeh Anvari Aliabad
International journal of reproductive biomedicine · 2025 · vol. 23(8) , pp. 627–636 · doi:10.18502/ijrm.v23i8.19811 · PMID:41306715 · PMC12477538
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Intra-ovarian platelet-rich plasma administration in poor responders resulted in a low spontaneous pregnancy rate, with significant differences in age, BMI, and AMH observed between pregnant and non-pregnant individuals.

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This cross-sectional study examined characteristics associated with spontaneous pregnancy in women with poor ovarian response (POR) who underwent intra-ovarian platelet-rich plasma (IO-PRP) injection, using Bologna criteria for POR and classifying women into POSEIDON groups based on pre-PRP ovarian reserve and related factors. From a larger cohort of 596 POR women with 2-year follow-up, 50 spontaneous pregnancies were identified, but only 42 were included in final analyses due to missing data; PRP preparation and dosing were described, and demographic, endocrine, ovarian, and spouse semen parameters were compared across POSEIDON groups. Significant between-group differences were found for women’s age, spouse age, BMI, serum AMH, and pre-intervention follicle/oocyte counts, with post-hoc comparisons showing specific pairwise distinctions. A key caveat is that the sample was limited to those with complete data, and the authors note that the highest observed prevalence of POSEIDON group 4 may reflect the underlying population composition rather than higher susceptibility. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

BACKGROUND: Female infertility, especially in those individuals with poor ovarian response (POR), is a challenge in the field of infertility and sterility. Recently, intra-ovarian platelet-rich plasma (IO-PRP) administration has been suggested as a possible co-treatment. OBJECTIVE: This study aimed to investigate the biodemographic characteristics of individuals who experienced spontaneous pregnancy following IO-PRP. MATERIALS AND METHODS: In this cross-sectional study, out of 1548 women diagnosed with POR who underwent IO-PRP, 596 individuals who completed their 2-yr follow-up period, were included. Different types of demographic and pre-intervention laboratory data (blood levels of anti-Müllerian hormone, luteinizing hormone, follicle-stimulating hormone, estradiol, prolactin, and their spouses' sperm analysis results) were collected from the files. Each individual was classified into a certain group according to the POSEIDON criteria, and their data were compared. RESULTS: The results showed that 50 (8.39%) spontaneous pregnancies were observed. However, 8 were excluded from further analyses due to missing data in their critical variables. The most prevalent POSEIDON group was 4, with a prevalence of 17/42 (40.47%). Among the POSEIDON groups, covariates including the age of the individuals and their spouses, body mass index, anti-Müllerian hormone, and antral follicle/oocytes count following the latest IO-PRP significantly differed (p < 0.001, p < 0.001, p = 0.039, p < 0.001, and p = 0.022, respectively). CONCLUSION: The spontaneous pregnancy rate following IO-PRP among women with POR was low. However, significant differences in biodemographic and hormonal characteristics were observed between the groups with and without spontaneous pregnancy which could be useful in leading future studies on this subject.
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M. Sanuie Farimani and R. Anvari Aliabad had full access to all of the data in the study and took responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: M. Sanuie Farimani and R. Anvari Aliabad. Acquisition, analysis, or interpretation of data K. Amiri and R. Anvari Aliabad. Drafting of the manuscript: K. Amiri and R. Anvari Aliabad. Critical revision of the manuscript for important intellectual content: All authors. Statistical analysis: K. Amiri. Supervision: M. Sanuie Farimani and R. Anvari Aliabad.

Coi Statement

The authors declare that there is no conflict of interest.

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