Platelet-rich plasma injection into the ovaries for IVF

What is Platelet-rich plasma injection into the ovaries for IVF?

PRP for IVF involves injecting a patient’s blood, processed to have a high level of platelets, into the ovaries

• Platelet-rich plasma (PRP) is made from a patient’s own blood and contains a higher concentration of blood platelets than normal blood.
• Plasma is the liquid part of blood and platelets are cells in blood that help with blood clotting and healing.
• Platelets produce growth factors and cytokines (small proteins) which help with blood clotting and healing of damaged blood vessels and tissues. Platelets also have anti-inflammatory properties.
• To create PRP, a blood sample is spun in a machine called a centrifuge to concentrate the platelets.
• In the context of IVF, PRP may be administered in two ways: injection into the ovary or infusion into the uterus. This information is about PRP injection into the ovary; some clinics refer to this as ‘ovarian rejuvenation’ (we also cover PRP infusion into the uterus).

Why might injection of PRP into the ovaries improve IVF outcomes?

• Platelets have anti-inflammatory properties and can help tissues to heal and regenerate
• PRP may help to “rejuvenate” the ovaries by improving blood flow, and support follicle growth and egg quality. These benefits may lead to a larger number of eggs being retrieved during IVF.

Why might injection of PRP into the ovaries not improve IVF outcomes?

• Some studies show increased ovarian reserve after PRP injection, which is measured by the Anti-Mullerian Hormone (AMH) or Antral Follicle Count (AFC). This raised hopes that PRP might help to grow new eggs, even though it is generally accepted that females are born with all the eggs they will ever have. The studies showing an increase in AMH or AFC after PRP have limitations such as the lack of a proper control group for comparison. Reliable studies, such as randomised controlled trials, have not shown improvement in AMH or AFC from PRP treatment.
• The ovaries are supplied by blood that contains a normal concentration of platelets. Additional platelets from PRP may not offer any benefit.

Who might consider injection of PRP into the ovaries for IVF?

People who have experienced

• Low ovarian response (low number of eggs retrieved in a previous IVF cycle)
• Premature ovarian failure (also known as early menopause or premature ovarian insufficiency (POI)).

Learn more about common IVF issues and challenges

Does injection of PRP into the ovaries for IVF work? What the evidence says

Only two small randomised trials are available and they don’t have much data. Therefore, it is unclear whether ovarian PRP injection (or ‘ovarian rejuvenation’) has any effect on the chance of live birth, pregnancy, or miscarriage.

Side effects of PRP injection into the ovaries

• Pain or discomfort following the procedure is common.
• Minor bleeding during or after the procedure from the ovary or the vagina. The bleeding is usually minimal, and the need for blood transfusion is very rare.
• A small risk of infection. This is rare and can usually be treated with antibiotics.  In severe cases it could require surgery to the ovary or removal of the ovary, but this is very rare.
• Accidental damage to nearby organs such as bowel, bladder or blood vessels during the procedure. This is a very rare complication.
• Adverse reactions to medications used for sedation or anaesthesia.
• Hypersensitivity or inflammatory reactions can result from any prepared blood product, but these are very rare. The symptoms of these reactions are diverse and range from skin conditions to anaphylaxis.

All medical procedures carry some risk. PRP injection into the ovary is a relatively new procedure and there is currently limited data about potential side-effects.

Risks of PRP injection into the ovaries and long-term outcomes

It is unknown whether there are any risks or long-term harms from PRP injection into the ovary

• This is based on data from randomised controlled trials and input from IVF specialists. Possible risks of harm and long-term outcomes are often not reported in randomised trials and therefore it is unknown whether platelet rich plasma poses any risk of harm to the IVF patient or the embryo/baby.

Ovarian PRP has been used in Australia since 2021, and approximately 600 IVF cycles have used PRP injection into the ovary.

Cost of PRP injection into the ovary for IVF

Platelet-rich plasma (PRP) usually costs between $900 – 5,000 AUD per injection procedure (for both ovaries). Multiple injection procedures may be recommended.

Cost information is indicative only, costs can vary from clinic to clinic and depending on different circumstances.

Practical considerations about ovarian PRP

PRP treatment procedure – ovarian injection

• Drawing blood
  • A blood sample taken – just like a regular blood test.
• Separating platelets
  • The blood is placed in a centrifuge machine which spins the blood rapidly, to produce a sample of plasma that is rich in platelets.
• Injecting the PRP
  • The PRP is then injected into each ovary in a procedure similar to an egg retrieval, typically performed vaginally under ultrasound guidance. A thin needle is inserted through the wall of the vagina into the ovary, to inject the PRP into the ovary. Sometimes the procedure is performed abdominally via a laparoscopy, where the needle is passed through the abdomen rather than the vagina. The procedure can be undertaken under local or general anaesthetic. PRP is usually injected into both ovaries.
  • In some cases, the IVF specialist may find it challenging to perform the procedure if the ovary is small and difficult to locate. In these cases the IVF specialist may not inject that ovary. In about 10% of cases only one ovary is injected. In about 2% of cases, neither ovary is injected.
  • PRP injection into the ovary usually takes place 1-3 months before starting an IVF cycle.

Unsure about some of the terms we have used? Use our glossary to understand scientific or unfamiliar terms.