Meta-analysis shows intraovarian PRP improves ovarian markers but pregnancy rates remain unchanged in women with poor reserve

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Frontiers in Medicine Published May 12, 2026 Medically reviewed May 12, 2026 DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Intraovarian PRP improves ovarian markers but does not significantly improve pregnancy rates in women with poor reserve.

This meta-analysis evaluated intraovarian autologous platelet-rich plasma (PRP) in women facing poor ovarian reserve or ovarian insufficiency. The study pooled data from 422 participants to assess the impact of this intervention on key reproductive metrics compared to control groups.

Results indicated significant improvements in several ovarian function markers. Antral follicle count increased with a mean difference of 0.81, while anti-Müllerian hormone levels rose substantially. Conversely, follicle-stimulating hormone levels decreased, and estradiol concentrations increased, all pointing toward enhanced ovarian activity.

Despite these favorable hormonal shifts, the analysis found no significant improvement in pregnancy rates. The authors caution that current evidence remains insufficient to define the optimal PRP regimen or identify the patient subgroups most likely to benefit from this approach.

Limitations included a limited number of studies and heterogeneity in treatment protocols. Consequently, findings should be interpreted cautiously until further research clarifies the clinical utility of intraovarian PRP for improving live birth outcomes.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundPoor ovarian reserve and ovarian insufficiency pose major challenges in reproductive medicine, with limited effective therapeutic options. Intraovarian autologous platelet-rich plasma (PRP) has shown potential benefits, but its efficacy remains uncertain based on current randomized controlled trials (RCTs).MethodsThis review followed PRISMA guidelines and was registered in PROSPERO (CRD420251233432). We systematically searched PubMed, Cochrane Central, Embase, CNKI, VIP, and Wanfang up to November 22, 2025, for randomized controlled trials of intraovarian autologous PRP in women with diminished ovarian reserve or ovarian insufficiency. Meta-analyses were performed using Stata 16, with heterogeneity assessed by the I² statistic. Risk of bias and study quality were evaluated using the Cochrane RoB 2 tool and the PEDro scale. Primary outcomes included serum anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), antral follicle count (AFC), and pregnancy rates.Result(s)This meta-analysis included seven RCTs involving 422 women with poor ovarian reserve or ovarian insufficiency/failure. PRP treatment was associated with significant improvements in several ovarian reserve-related parameters: AFC increased (MD = 0.81, 95% CI 0.31 to 1.30; I² = 41.63%), AMH increased (SMD = 0.91, 95% CI 0.41 to 1.42; I² = 54.32%), FSH decreased (MD = -5.72, 95% CI -7.03 to -4.41; I² = 0.00%), and estradiol increased (MD = 26.03, 95% CI 19.53 to 32.53; I² = 0.22%). However, PRP treatment did not significantly improve pregnancy rates compared with controls.ConclusionsThis meta-analysis suggests that intraovarian PRP may improve ovarian reserve-related markers in women with poor ovarian reserve or ovarian insufficiency/failure, but it does not appear to increase pregnancy rates significantly. These findings should be interpreted cautiously because of the limited number of studies and heterogeneity in treatment protocols, and current evidence remains insufficient to define the optimal PRP regimen or the patient subgroups most likely to benefit.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251233432, identifier CRD420251233432.