A new approach of using platelet-rich autologous plasma to increase the ovarian reservoir in a Syrian patient with ovarian insufficiency: A case report. (January 2022)

• Record Type: Journal Article
• Authors: Sabouni, Rami; Tarrab, Rand; kalaji, Dania; Abbassi, Haitham
• Is Part Of: Annals of medicine and surgery. Volume 73(2022)
• Publication Date: 2022-01
• Subjects: Platelet-rich plasma -- Iatrogenic -- Primary ovarian insufficiency -- Treatment -- Diminished ovarian reserve -- Premature ovarian failure -- Infertility -- Ovarian insufficiency; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2021.103149
• Languages: English
• ISSNs: 2049-0801

Abstract

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. Highlights: Primary ovarian insufficiency effect 1–2% of all women. It is a major problem in countries where donor eggs programs are not acceptable. Ovarian rejuvenation using platelet-rich plasma showed promising results. The combination of generalized and localized effects may enhance the outcomes.