A new approach of using platelet-rich autologous plasma to increase the ovarian reservoir in a Syrian patient with ovarian insufficiency: A case report

Abstract

Introduction: The prevalence of Primary ovarian insufficiency (POI) is estimated to be 1-2%, resulting from many causes, including, iatrogenic causes which are becoming more common.There is no precise treatment to restore fertility in POI patients. However, new treatments -such as ovarian rejuvenation using platelet-rich autologous plasma (PRP)- are being tested and have shown promising results. We report using a new PRP injection protocol to manage a Syrian patient with ovarian insufficiency.

Case presentation: A 35-year-old woman with five years of primary infertility presented with decreased anti-mullerian hormone (AMH) after she underwent a laparoscopy one year ago. Where the AMH dropped from 1.07 to 0.39 ng/mL after it. She underwent an ovarian rejuvenation using PRP. Half mL of PRP was injected into every ovary, 2 mL were injected into the cervix, 7 mL intra-uterus, and 7 mL were injected intramuscularly to the patient's legs. Fifteen days following the operation, the patient's new AMH level was 0.94 ng/mL. The patient was placed on ovarian stimulation, and five days later the ultrasonography showed the development of six follicles in each ovary.

Discussion: Managing POI using ovarian rejuvenation is the best alternative treatment; When the donor eggs programs are not acceptable. The use of PRP in ovarian rejuvenation has been reported to be effective.

Conclusion: The use of PRP was beneficial in restoring fertility in a Syrian patient with ovarian insufficiency. Furthermore, the new PRP injection protocol was successful. However, more studies are needed to confirm this result.

Keywords: Diminished ovarian reserve; Iatrogenic; Infertility; Ovarian insufficiency; Platelet-rich plasma; Premature ovarian failure; Primary ovarian insufficiency; Treatment.

Fig. 1

Transvaginal ultrasound of the Right ovary. Fig. 1 legend: the ecography shows the development of four follicles ranged between 1.3 and 1.5 cm in diameter.