Early ovarian reserve decline (EORD) and premature ovarian insufficiency (POI) pose major challenges in reproductive medicine, as few interventions can truly restore ovarian function or fertility. Conventional hormone replacement therapy alleviates symptoms but fails to rejuvenate the ovarian microenvironment, prompting growing interest in regenerative approaches such as platelet-rich plasma (PRP) therapy. This review critically evaluates the therapeutic potential of intraovarian PRP injection for women with EORD and POI, integrating mechanistic insights, preclinical findings, and clinical evidence to clarify its biological rationale and translational challenges. We systematically synthesized literature on PRP composition, preparation methods, and reproductive applications. Mechanistic data from animal and cell models were combined with evidence from clinical studies to elucidate how PRP modulates angiogenesis, follicular activation, apoptosis, and immune regulation through pathways such as PI3K/Akt, MAPK, and mTOR. PRP delivers a rich concentration of growth factors, cytokines, and extracellular vesicles that orchestrate angiogenesis, suppress apoptosis, and remodel the ovarian niche. Preclinical and early clinical studies consistently report improved ovarian reserve markers, partial hormonal recovery, and resumption of menses in some patients, although heterogeneity in protocols and limited sample sizes hinder definitive conclusions. Intraovarian PRP represents a biologically plausible and minimally invasive regenerative strategy for ovarian rejuvenation. Future research should prioritize the development of standardized preparation protocols, biomarker-guided patient selection, and large multicenter randomized trials to confirm its safety, efficacy, and long-term clinical value.
Hu et al. (Tue,) studied this question.