Ovarian Platelet-Rich Plasma Converts Previously Nonproductive or Cancelled IVF Cycles into Viable Retrievals in Poor Responders

Objective: To determine whether ovarian PRP improves ovarian response and enables cycle completion in patients with diminished ovarian reserve or prior poor IVF response. Design: Retrospective cohort study. Materials and Methods: Patients undergoing IVF cycles before and after PRP were evaluated for antral follicle count (AFC), oocyte yield, mature oocytes, and cycle outcomes, including prior cycle cancellation or minimal response. Stimulation protocols and gonadotropin dosing were also assessed. Results: Following PRP, an increase in baseline AFC was observed in 9 of 17 evaluable patients, with representative improvements including AFC increases from 2 to 5, 3 to 6, and 10 to 14. Oocyte yield increased in 11 of 17 patients, with notable individual improvements including 11 to 21 oocytes, 21 to 38 oocytes, and 26 to 43 oocytes. Mature oocyte (MII) counts increased in 10 of 17 patients, paralleling overall oocyte yield improvements. Patients with prior cycle cancellation or extremely poor response (n = 3), including one patient with a previously cancelled cycle due to lack of follicular development and another with conversion to intrauterine insemination, were able to proceed to oocyte retrieval following PRP. Among 5 patients who previously produced no embryos, 3 demonstrated embryo development in subsequent cycles after PRP, including development of cleavage-stage embryos and blastocysts. Additionally, two patients conceived spontaneously following PRP while preparing for subsequent IVF cycles. These improvements occurred despite similar or only modestly increased gonadotropin dosing in most patients, suggesting the observed effect was not solely attributable to changes in stimulation protocols. Conclusions: Ovarian PRP may enhance ovarian responsiveness and facilitate successful retrieval in patients with prior poor response or cancelled cycles. This approach may offer a potential therapeutic option for a population with otherwise limited treatment success.