Hello doctor, I had done first IVF last year, but it failed due to a bad quality egg. Embryos were not developed after two days. AMH level is 1.52, and the egg count was low. On consulting another doctor, she suggested to go with PRP injection to rejuvenate the ovary, so that egg count and quality will increase. I am afraid if PRP will cause any harm to the ovary? Are there any issues to try PRP?
Hello. You have been wrongly guided by your doctor because there is no apparent need for PRP (platelet rich plasma) therapy and injection into ovaries to rejuvenate the ovaries to produce better quality eggs. The therapy modality is relatively new and not sufficient studies have been done yet on them. It is being done for women with really low antral follicular count and AMH (anti-mullerian hormone) less than one and failed two natural timed intercourse and six IUI (intrauterine insemination) and one IVF (in vitro fertilization) cycles. You were directly subjected to IVF cycle, which was wrong without treating the pathology. AMH can be increased with DHEAS (dehydroepiandrosterone) therapy which is oral supplementation along with low dose OC pill (oral contraceptive) therapy for two months. That improves the quality and also the chances of natural conception. Also, another concern is a bicornuate uterus, which has their own demerits for natural conception so that IUI can be offered for conception at least for six cycles, post-therapy. If succeeded, then the bicornuate uterus is unable to sustain the pregnancy for the complete term, and often preterm labor occurs giving birth to a preterm baby. So weigh this complication as well in your mind. You can either opt for Strassman's operation first to increase the size of the uterus by joining them together and then try after a year or take the risk of IUI or IVF and accept complications associated with bicornuate uterus itself. You have to think and make a decision. PRP is the last line of therapy, not primary, in my opinion.