Patsama Vichinsartvichai, 

MD, MClinEmbryol, EFOG-EBCOG, EFRM-ESHRE/EBCOG. 

20 Jan 2024

There is more emerging information about the injection of platelet rich plasma  (PRP) into the ovaries to help restore the quality of the egg cells, making the embryos better. The working mechanism of PRP is thought to be caused by many growth factors that are secreted from platelets to help restore the stimulation of the egg bag that is not working and may stimulate the oogonial stem cell to change to egg cells, making the number and quality of egg cells better. As shown in picture 1

Indications for PRP injection at the ovary

PRP injection at the ovary in infertile people has the following indications.

1. 1. 1. Over 40 years old

      2. Low number of initial eggs (AFC) or low AMH

      3. I used to stimulate the egg to make IVF and get less than 5 eggs.

      4. Abnormal embryonic development has little blastocyst.

      5. All abnormal embryo chromosomes (need more research information)

When can PRP injections in the ovaries?

It is generally recommended to inject after menopause within 7-10 days. In women who has no period, it can be done any day. 

What is the PRP injection procedure at the ovary?

The following steps are follows for PRP injection in the ovary:

1. 1. 1. Refrain from water and food at least 6 hours before the procedure begins.

      2. There will be a blood collection to prepare PRP and check for sexually transmitted diseases and AMH hormones using about 30-40 ml of blood and intravenous water.

      3. Prepare PRP in the laboratory, it takes about 30 minutes.

      4. PRP injection, which will receive painkillers and fall asleep first. After that, the doctor will inject PRP at the ovaries through vaginal ultrasound. (Similar to egg collection) and will count the initial number of eggs (AFC) with a total of about 15 - 20 minutes.

      5. Recuperate in the recovery room, when you are awake, the nurse will remove the line to give the saline and be able to go home.

What is the recommendation after PRP injection at the ovary?

After the PRP injection, there may be a slight vaginal bleeding for the first 1-2 days, including the pain of both lower abdomen. The clinic will have painkillers to eat.

However, if you notice that there are other abnormal symptoms or the symptoms do not improve, please contact the clinic to see a doctor immediately.

How do I know if PRP work?

After injecting PRP at the ovaries, there will be an appointment to check when the next menstrual period comes on the 2-3rd day of the menstrual cycle. There will be a blood test, hormone AMH and vaginal ultrasound to count the number of eggs (AFC).

Does PRP work for everyone? What are the factors of success?

Those who inject PRP at the ovaries may not be all results. By finding that about 80% of the results, found that the factors that affect success are

1. 1. People who have had ovarian surgery, especially from chocolate, are less likely to be effective.

   2. The concentration of PRP after preparation should be at least 1,000,000 per ml or more.

PRP 3.0

PRP preparation does not have a commonly used standard method. This makes a variety of platelet concentrations from 3 times to 15 times. The difference of each hospital is Blood vessels used to collect blood, the strength of spinning, time used to ride, etc., as shown in picture 3, by the present at LIFE by Dr. Pat, we have chosen a PRP preparation tube, technology from Korea that makes platelets as concentrated as 12-15 times as blood before preparing. In order for patients to get the highest treatment efficiency

Case example

The 47-year-old patient came to consult with the doctor about wanting to have a child. Initially, the ultrasound test found only 1 AFC on each side. The AMH test found that it was less than 0.1 ng / ml. Therefore, it was recommended that the patient to inject PRP with the ovaries. The PRP was prepared to find that the concentration of 1.3 million / mL. One month later, after the PRP injection was tested, the AMH was found that it increased to 1.47 ng / ml and has 7 eggs.