Autologous platelet-rich plasma ovarian injection was associated with increased oocyte acquisition in patients with poor ovarian response: a retrospective propensity-matched study

Abstract Background Women with poor ovarian response (POR) tended to have lower success rates for IVF/ICSI due to fewer oocytes retrieved. Autologous platelet-rich plasma (PRP) had been proposed to improve ovarian response.Method This study aims to evaluate the impact of autologous PRP ovarian injections on oocyte retrieval numbers and other reproductive outcomes in IVF/ICSI cycles among infertile women with POR, as defined by the Bologna criteria. Conducted at the Reproductive Center of the Sixth Affiliated Hospital of Sun Yat-sen University, this retrospective analysis involved a total of 1,833 oocyte retrieval cycles. Among these, 91 cycles involved patients who received autologous PRP injections, while 261 cycles were included in the control group after applying propensity score matching.Results The PRP group showed a significant increase in the number of follicles ≥ 14mm(2.96 ± 1.79 versus 2.26 ± 1.44, P < 0.001), retrieved oocytes(2.86 ± 1.88 versus 2.07 ± 1.78, P < 0.001), and normally fertilized zygotes(1.73 ± 1.42 versus 1.337 ± 1.44, P = 0.044) compared to the control group. Although the number of transferable embryos(1.34 ± 1.21 versus 1.07 ± 1.26, P = 0.079) and high-quality embryos(1.09 ± 1.16 versus 0.83 ± 1.13, P = 0.066) was higher in the PRP group, these differences were not statistically significant. Multivariable logistic regression identified PRP injection(odds ratio [OR] 3.655, 95% confidence interval [CI] 0.324–1.079, P < 0.001), AMH levels(OR 4.096, 95% CI 0.949–2.701, P < 0.001), and total gonadotropin dose( OR 2.899, 95% CI < 0.001–0.001, P = 0.004) as independent predictors for oocyte retrieval.Conclusion Autologous PRP ovarian injection was associated with an increased number of oocytes retrieved in patients with poor response. While embryo quality improvement was not significant, PRP shows potential for enhancing reproductive outcomes in this population. Further randomized controlled trials are warranted.