In Vitro Fertilization has opened the doors to parenthood for millions of couples struggling with natural conception. 13 million babies to date have been conceived with the assistance of IVF, with roughly five hundreds of thousands more born each year. Unfortunately, this number falls short of the number of couples attempting IVF. While IVF helps overcome barriers to fertilization, it cannot address a subsequent challenge: embryo health, a factor that ultimately determines the success of pregnancy. More than half of aspiring parents undergoing treatment still fail to conceive or maintain healthy pregnancies due to the limited knowledge on the physiological conditions of their own bodies.
These gametes were fertilized with the sperm, resulting in an embryo which was grown into blastocysts in an in vitro medium.
Researchers have looked beyond embryo treatment for the answer. Intraovarian platelet-rich plasma injections emerged as a promising solution. This treatment aims to improve the health of the female egg cells prior to fertilization by supplying it with nutrients from the mother’s blood. One of the most recent studies on the treatment, published in the scientific journal Nature, has offered promising results for the treatment, based on an experiment conducted on 74 patients. Researchers from the Lee Women’s Hospital in Taiwan found that intraovarian platelet-rich plasma injections pre-fertilization have had positive post-fertilization effects on the quality of blastocysts.
These seeds of life may need their mother’s blood to germinate
Intraovarian Platelet-rich Plasma (PRP) Injections for Patient prior to Ovulation
Blood flow is a crucial, arguably symbolic, process that fuels life. Blood is composed of red blood cells, whose primary role is oxygen delivery, and plasma, which is the solvent in which platelets, thousands of nutrient and protein types are delivered to individual cells. Utilizing this nutrient-dense solvent, PRP injections extract plasma from the blood to supply other organs. As the word intraovarian suggests, the organ in question here is the ovary. The ovary contains oocytes that mature into egg cells, which are female gametes that participate in fertilization.
Platelet-rich plasma is highly rejuvenating due to its diverse composition:
- Proteins, which can serve as clotting factors, or stimulate intracellular metabolic processes and intercellular communication processes.
- Cytokines, which are immune proteins that allow chemical signaling between the immune system and other cells.
- White blood cells that enhance immune response, and platelets, which are cell fragments that contain many cytoplasmic proteins and promote clotting at wound sites.
- Growth factors and hormones that can stimulate cell proliferation and maturation.
PRP injections make a potent wound-healing treatment that is widely used in surgery in orthopedics and obstetrics and gynecology to treat sexual or pelvic floor disorders. This use suggested that PRP injections in ovaries may promote the health and growth activities of oocytes, which would subsequently promote embryo health. As it is derived from the patient’s own blood, it is relatively low-risk in autoimmune complications. Of the 74 patients in the experiment, PRP injections were done on 44 patients at their follicular phase in the ovarian cycle, when follicles are growing and the endometrium walls thicken. This allows the oocytes to receive platelet-rich plasma before it matures in the ovulation phase.
Evaluation of Blastocyst Quality after PRP Injections
Researchers induced ovulation using controlled ovarian hyperstimulation (COH). This technique is commonly used in IVF to induce multiple oocyte maturation using human hormones with the aim of obtaining a larger yield of gametes, which are egg cells that participate in fertilization in females. Progestin, the synthetic version of the female reproductive hormone progesterone, is used to stimulate ovulation to receive more egg cells.
A COH cycle was also done for all patients prior to treatment, and found that the quantity and quality of blastocysts were similar in all patients. The procedures were performed again in the immediate cycle for the control group, and after the injection treatment for the PRP group. COH was done typically during the ovulation phase of the patient’s ovarian cycle following the follicular phase, allowing researchers to obtain oocytes that had received PRP injections.
Improvement of blastocyst quality
In the second COH cycle performed, after the PRP group had received their injection, the average rate of total blastocysts had more than doubled in the PRP group, while the rate of good quality blastocyst increased from an average of 1% in the control group to 14% in the PRP group. There was a significant increase in total blastocysts and good quality blastocysts. It answered their hypothesis with a positive outcome: Intraovarian PRP injection induced a notable improvement in the quantity and quality of blastocysts.
The group with PRP injections also had more blastocysts available to be analyzed through preimplantation genetic testing for aneuploidy (PGT-A), a diagnostic test to find if the embryonic cells have the correct number of chromosomes (euploidy), if it is irregularly numbered (aneuploidy) or if it is mixed with euploid and aneuploid cells (mosaic). Down syndrome is an example of aneuploidy. In the control group, only two patients out of 30 had one blastocyst available for PGT-A, and only one of which was euploid but resulted in a miscarriage. The PRP group, in contrast, had 22 patients with available blastocysts to analyze, which resulted in a 17.6% euploidy rate and 20.6% mosaic rate.
Researchers theorized that the diverse composition of growth factors and hormones may be responsible for the enhanced embryo quality. This nutrient-rich blood can stimulate more oocytes to undergo second meiosis and mature to more viable egg cells. These egg cells have better health due the supply of nutrients and immunity from PRP injections, allowing for better growth of the embryo into blastocysts.
Potential in Assisted Reproductive Technology
IVF has gone a long way in enabling the dream of children for many families, but there are yet many challenges with optimizing the male and female gametes in preparation for in vitro fertilization. Intraovarian PRP injections may be the exhaustive solution to this challenge. Perhaps babies need milk even before they are born. PRP may be the maternal milk that embryos need to survive.
References
Yu, TN., Chen, MJ., Lee, TH. et al. Intraovarian platelet-rich plasma injection significantly improves blastocyst yield and quality in IVF patients. Sci Rep 15, 1301 (2025). https://doi.org/10.1038/s41598-024-82630-1
Source image: https://pixabay.com/photos/blood-sample-test-tube-covid-test-6200015
