Ovarian rejuvenation with PRP is an emerging approach in reproductive medicine that uses platelet-rich plasma prepared from a woman’s own blood. PRP contains a high concentration of platelets and growth factors involved in tissue repair and regeneration and is injected directly into the ovaries with the aim of supporting ovarian function.
The treatment has been investigated mainly in women with diminished ovarian reserve, low AMH levels, poor response to ovarian stimulation or premature ovarian insufficiency, particularly when previous IVF cycles have produced a limited number of eggs.
However, ovarian PRP is still considered an experimental fertility treatment. Current scientific evidence is not sufficient to confirm that it improves egg quality, pregnancy rates or live birth rates, and its potential benefits should therefore be discussed carefully with a fertility specialist before treatment.
A thorough fertility assessment, including the woman’s age, ovarian reserve, hormonal profile and previous response to IVF treatment, is essential to determine whether ovarian PRP may be considered in an individual case.
What Is Ovarian Rejuvenation with PRP?
Ovarian rejuvenation with PRP is a fertility treatment in which platelet-rich plasma (PRP) prepared from a woman’s own blood is injected directly into the ovaries. The technique is being investigated as a possible way to influence ovarian function and response to stimulation, particularly in women with diminished ovarian reserve or a previous poor response during IVF treatment. Current evidence, however, remains limited and does not confirm that ovarian PRP improves the chance of having a baby.
What Is Platelet-Rich Plasma (PRP)?
Platelet-rich plasma is an autologous blood product, meaning that it is obtained from the patient’s own blood. A small blood sample is processed in a centrifuge to separate its components and produce plasma with a higher concentration of platelets.
Platelets contain proteins and growth factors involved in normal tissue repair, healing and cellular signalling. PRP has therefore been used in several medical fields where tissue regeneration is of interest. In reproductive medicine, researchers are studying whether these biological properties may also have an effect on ovarian tissue.
How Is PRP Used in Reproductive Medicine?
For ovarian treatment, PRP is injected directly into the ovarian tissue, usually through a transvaginal approach. The aim is to investigate whether exposure to concentrated platelets and growth factors may influence the ovarian environment and potentially improve the response of the ovaries to subsequent stimulation.
This approach is sometimes referred to as ovarian PRP, intraovarian PRP or ovarian rejuvenation. The term “rejuvenation”, however, should not be interpreted as meaning that the treatment can reverse ovarian ageing or create new eggs. At present, there is insufficient evidence to establish that PRP can reliably increase ovarian reserve, improve egg quality or increase pregnancy and live birth rates.
Who May Be Considered for Ovarian PRP Treatment?
Ovarian PRP has mainly been investigated in women with diminished ovarian reserve, poor ovarian response to IVF stimulation or premature ovarian insufficiency. Whether the treatment is appropriate should always be assessed individually, taking into account the woman’s age, ovarian reserve, previous fertility treatment and overall reproductive history.
Diminished Ovarian Reserve and Low AMH
Women with diminished ovarian reserve (DOR) have a lower number of remaining follicles compared with what may be expected for their age. This may be reflected by a low AMH level, a reduced antral follicle count (AFC), or both.
Intraovarian PRP has been studied in this group with the aim of investigating whether it could influence ovarian activity or the response to subsequent ovarian stimulation. However, an increase in AMH or other ovarian reserve markers cannot be guaranteed, and current evidence does not establish that PRP increases the chance of a live birth.
Poor Response to IVF Stimulation
Ovarian PRP may also be discussed in selected women who have previously shown a poor ovarian response during IVF, such as developing only a small number of follicles or retrieving a limited number of eggs despite ovarian stimulation.
Before considering PRP, the fertility specialist should review previous IVF cycles, medication protocols, ovarian reserve tests and other factors that may have influenced the response.
Premature Ovarian Insufficiency or Perimenopause
PRP has also been investigated in women with premature ovarian insufficiency (POI) or declining ovarian function during the perimenopausal years.
Research is exploring whether intraovarian PRP could influence residual ovarian activity in selected patients. It is important, however, to have realistic expectations. PRP has not been proven to reverse ovarian ageing, restore a depleted ovarian reserve or reliably enable the ovaries to produce viable eggs.
For this reason, ovarian PRP should be considered only after a detailed fertility evaluation and discussion of the available evidence, potential limitations and other reproductive treatment options.
How Is Ovarian PRP Performed?
Ovarian PRP treatment involves preparing platelet-rich plasma from the woman’s own blood and then injecting it directly into the ovaries. The procedure is usually performed under ultrasound guidance using a transvaginal approach similar to that used during egg retrieval.
Preparation of Platelet-Rich Plasma
A small amount of blood is first collected from the patient. The blood is then processed in a centrifuge to separate its different components and obtain plasma with a higher concentration of platelets.
Because PRP is prepared from the patient’s own blood, it is described as an autologous treatment. Once the platelet-rich plasma has been prepared, it can be used for the ovarian injection.
PRP Injection into the Ovaries
The prepared PRP is injected into the ovarian tissue through the vagina under ultrasound guidance. A fine needle is introduced into each ovary in a procedure that resembles transvaginal oocyte retrieval during IVF.
Mild sedation may be used to make the procedure more comfortable. The exact timing of ovarian PRP may depend on the woman’s menstrual cycle, fertility history and the treatment protocol recommended by the fertility specialist.
The purpose of the injection is to expose ovarian tissue to concentrated platelets and growth factors in an attempt to influence the ovarian environment and response to subsequent stimulation. However, intraovarian PRP remains a fertility treatment add-on with limited evidence regarding its effectiveness.
What Happens After Ovarian PRP?
Ovarian PRP is generally performed as a short procedure, and most women can return to their usual daily activities after recovery from sedation.
Follow-up may include hormonal blood tests and ultrasound examinations to reassess ovarian function and determine whether there has been any change in ovarian response. Depending on the individual case, the fertility specialist may monitor parameters such as AMH, FSH and antral follicle count before deciding on the next stage of fertility treatment.
Changes in these markers should be interpreted cautiously. Current evidence does not establish that improvements in ovarian reserve markers after PRP necessarily translate into better pregnancy or live birth rates.
Is Ovarian Rejuvenation with PRP Safe and Effective?
Ovarian PRP is prepared from the woman’s own blood, which avoids the risk of disease transmission from a donor and reduces the likelihood of an immune reaction. However, the procedure itself is not completely free of risk, and its effectiveness in fertility treatment has not yet been established.
Is Ovarian PRP Safe?
Because PRP is an autologous treatment, the material injected into the ovaries comes from the patient herself. Nevertheless, intraovarian injection is an invasive procedure and potential complications may include:
- pelvic discomfort or pain,
- bleeding,
- infection,
- complications related to sedation or anaesthesia,
- injury associated with transvaginal ovarian injection.
The HFEA also notes that PRP preparation and administration are not yet fully standardised and that available studies provide limited information about long-term safety.
Does Ovarian PRP Improve Fertility?
Research has investigated whether intraovarian PRP may improve ovarian response, ovarian reserve markers or the number of eggs retrieved in women with diminished ovarian reserve.
Some studies have reported changes in parameters such as AMH levels or the number of retrieved oocytes. However, results across studies are inconsistent, and current evidence does not demonstrate that ovarian PRP reliably increases the chance of pregnancy or live birth.
The HFEA currently rates intraovarian PRP red for women with poor or diminished ovarian reserve, because there are potential safety concerns and no moderate- or high-quality evidence showing that it improves the chance of having a baby.
The Importance of Individual Fertility Assessment
Before considering ovarian PRP, every woman should undergo a comprehensive fertility assessment. This may include evaluation of:
- age and reproductive history,
- AMH and other hormonal tests,
- antral follicle count (AFC),
- previous response to ovarian stimulation,
- previous IVF outcomes,
- other factors that may affect fertility.
These findings allow the fertility specialist to discuss realistic expectations and determine which treatment options may be most appropriate.
Ovarian PRP should therefore not be presented as a proven method of reversing ovarian ageing or restoring ovarian reserve. It remains an investigational fertility treatment, and any decision to consider it should be based on careful counselling about the current evidence, possible risks and available alternatives.
