When is the ideal time for Ovarian PRP Treatment?

Ovarian PRP (Platelet-Rich Plasma) treatment is an innovative procedure designed to rejuvenate ovarian tissue and enhance follicular development in individuals with diminished ovarian reserve, poor ovarian response, or premature ovarian insufficiency. PRP is derived from the patient’s own blood through centrifugation, concentrating platelets and growth factors such as platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), and transforming growth factor-beta (TGF-β). These bioactive molecules promote cellular repair, angiogenesis, and the activation of dormant ovarian follicles by stimulating granulosa cells and improving the ovarian microenvironment. The goal of ovarian PRP therapy is to restore or enhance ovarian function, thereby improving oocyte quality, hormonal activity, and the chances of achieving a successful pregnancy, particularly in the context of fertility treatments like in vitro fertilization (IVF).

One of the questions we receive is with regard to timing of an ovarian PRP treatment. While ovarian PRP treatment is likely to be beneficial at any time during the ovarian cycle given the presence of growth factors, there is a “most ideal” time where maximum benefits may be realized. Again, ovarian PRP treatment, when done appropriately, is likely to offer benefits regardless of when it is performed during an ovarian cycle, and in some cases, due to convenience purposes, it may be offered at the same time of an oocyte retrieval to help with subsequent oocyte collections. Nevertheless, building upon some physiological principles, we can say that the most optimal ovarian PRP treatment is timed during the early follicular phase of the ovarian cycle, which is Day 3 to Day 5 of menstruation. This timing is chosen for the following reasons:

1. Optimal Follicular Development Environment: During the early follicular phase, the ovaries are in a resting state with minimal hormonal activity. This creates a more stable environment for the regenerative effects of PRP, potentially enhancing follicular recruitment and growth.

2. Low Hormonal Influence: At this point, estrogen and progesterone levels are at their lowest. Introducing PRP at this time minimizes interference from fluctuating hormonal levels, allowing PRP to act directly on ovarian tissue.

3. Targeting Dormant Follicles: The early follicular phase is when the pool of dormant primordial follicles is being primed for selection. PRP may stimulate these follicles, promoting their growth and maturation. In fact, primordial follicles are the main target of ovarian PRP treatments. Therefore, aiming for day 3-5 of menstruation can give us an additional benefit.

4. Improved Monitoring and Alignment with an IVF cycle: Performing PRP early in the cycle allows for subsequent monitoring of ovarian response during the same cycle. This can guide additional treatments, such as controlled ovarian stimulation, if multiple oocyte collections are being planned. This way, ovarian PRP treatment’s benefits on both the antral follicles and the primordial follicles can be harnessed. 

Once an ovarian PRP treatment is performed, an IVF cycle can be planned immediately within the same cycle in order to retrieve oocytes that were in antral state at the time of ovarian PRP application. However, if only one egg retrieval is planned after an ovarian PRP treatment, then the most ideal time would be 12 weeks after the ovarian PRP treatment as this is when primordial follicles would have enough time to respond. In an ideal world, we would recommend two oocyte retrievals after an ovarian PRP treatment in order to obtain maximal number of benefits from treatment.

Contact one of our patient coordinators for more information!