Abstract
Author(s): Wasan Adnan Al-Jubori, Muayad Sraibet Abbood*
Background: Poor ovarian reserve significantly reduces reproductive potential by lowering ovarian follicle quantity and quality. Many recent therapeutic strategies have shown potential benefits in improving ovarian function. Objective: To evaluate the effects of platelet-rich plasma, growthstimulating factors, and their combination injection on ovarian function parameters in females with diminished ovarian reserve. Patients and method: A prospective analytical (clinical trial) study was conducted on infertile females referred to the Infertility Department of Higher Institute for infertility Diagnosis and Assisted Reproductive Technologies, Baghdad, Iraq between July 2023 and December 2024. Sixty females aged 25–45 years who were diagnosed to have poor ovarian reserve were randomly divided into three equal groups depending on injected substance on day 6-7 of the menstrual cycle into platelet-rich plasma, Granulocyte Colony-Stimulating Factor, and combined therapy (PRP + GSF) groups. Primary outcome included ovarian artery Resistance Index, Anti-Müllerian Hormone, antral follicle count, and follicle size. Secondary outcome involved an assessment of parameters 1–3 months post-intervention. Results: Platelet-rich plasma alone significantly reduced ovarian Resistance Index (p=0.034). Granulocyte Colony-Stimulating Factor significantly increased Antral Follicle Count (p=0.027), indicating improved follicular recruitment. The combined treatment (PRP + GSF) significantly decreased Resistance Index (p<0.001), increased Antral Follicle Count (p=0.002), and enhanced follicle size (p=0.002). AMH changes varied, suggesting individualized responses. Conclusion: Platelet-rich plasma, Granulocyte Colony-Stimulating Factor, and their combination significantly improved ovarian function.