Efficacy of combined PRP therapy and Fertizil F for ovarian function restoration in late reproductive–age women with low ovarian reserve: a controlled prospective study

Abstract

Background. Diminished ovarian reserve (DOR) represents a major challenge in current reproductive medicine. With advancing age, both the quantity and quality of ovarian follicles decline, impairing ovarian function, reducing conception rates, and complicating pregnancy maintenance.Aim. To assess the efficacy of intraovarian injections of autologous platelet‐rich plasma (PRP) combined with oral administration of the mitochondrial complex Fertizil F for restoring ovarian function in late reproductive–age women with DOR. Methods. In this controlled prospective study, 120 women aged 35–41 years with DOR (AMH < 1.0 ng/ml and AFC < 5 per POSEIDON Groups 3–4) were enrolled. Participants were randomized into three groups:Group I (n = 50): single intraovarian PRP injection plus Fertizil F (2 capsules daily for 12 weeks), Group II (n = 40): single intraovarian PRP injection only,Control (Group III, n = 30): standard therapy without PRP or Fertizil F Baseline and 3‐month follow‐up assessments included hormonal markers (AMH, FSH, LH, estradiol), ultrasound parameters (AFC, endometrial thickness), Doppler indices (PI and RI of uterine arteries), and clinical outcomes (ovulation rate, pregnancy rate). Results. Compared with Groups II and III, Group I demonstrated significant improvements: AMH increased by +0.36 ng/ml (95% CI 0.31–0.41; p < 0.001), AFC by +2.4 follicles (95% CI 2.0–2.8; p < 0.001), and endometrial thickness by +1.9 mm (95% CI 1.5–2.3; p < 0.01). Ovulation rate in Group I reached 70% versus 46.7% and 26.7% (OR = 6.8; 95% CI 2.4–19.2; p < 0.001), and pregnancy rate was 36% versus 20% and 10% (OR = 5.2; 95% CI 1.8–15.0; p < 0.001). Conclusion. The combination of intraovarian PRP injections and oral Fertizil F is safe and effective for restoring ovarian function, improving ovarian reserve markers, and enhancing clinical outcomes in late reproductive–age women with DOR. This protocol merits integration into assisted reproductive technology practice.