Efficacy of Autologous Platelet-Rich Plasma in Ovarian Stimulation and In Vitro Fertilization: Impact of Obesity on Reproductive Outcomes

Purpose To evaluate the effectiveness of intraovarian autologous platelet-rich plasma (PRP) on controlled ovarian stimulation (COS) and in vitro fertilization (IVF) outcomes, and to assess the potential modifying role of obesity on treatment response. Methods This retrospective self-controlled study included 299 women (25–49 years) with a history of at least one failed IVF cycle who received intraovarian PRP between September 2021 and January 2024. Patients underwent COS and IVF post-treatment. Outcomes included hormonal response, cycle cancellation rate, number of retrieved oocytes, embryo development, and pregnancy rates. Using BMI, patients were stratified into normal weight (18.5–24.9 kg/m²), overweight (25.0-29.9 kg/m²), and obese (≥ 30.0 kg/m²). Results Following PRP treatment, the COS cycle cancellation rate significantly decreased from 32.6% to 11.1% (p < 0.001). Improvements were seen across all BMI categories. The number of transferable embryos increased (p = 0.035), and implantation rates rose from 2.0% to 14.0% (p < 0.001). A significant increase in ongoing pregnancy/live birth rates was observed (0.0% vs. 10.4%, p < 0.001). Obese patients showed improvement but had less favorable implantation outcomes. PRP was generally safe, though mild to moderate bleeding occurred in a subset of patients. Conclusion Intraovarian PRP appears to enhance COS and IVF outcomes, particularly by improving embryo development and implantation. However, obesity may attenuate these effects. Further randomized controlled trials are needed to confirm efficacy and optimize patient selection and treatment timing.