For patients hoping to try IVF with their own eggs, ovarian “rejuvenation” offers a possibility—not a proven improvement in the chance of having a baby—a distinction central to the cautious approach of Dr Harry Karpouzis, Founder & Scientific Director at Pelargos Fertility Group in Athens.
What does “rejuvenation” actually promise?
The word rejuvenation can suggest that an ovary can be made young again. Yet neither platelet-rich plasma (PRP) nor stem cell-based ovarian treatments have been shown to reverse the chromosomal ageing of eggs. Both remain experimental, and neither has conclusive evidence of improving live birth rates.
The more modest possibility is that treatment might help recruit additional follicles already present in the ovaries. Some studies suggest improvements in hormone levels and follicle numbers, potentially allowing a patient to obtain more eggs during ovarian stimulation. That is a different claim from making those eggs healthier or increasing the chance of taking home a baby.
This distinction matters when weighing whether to spend time and money on an additional procedure. A better blood-test result may be encouraging, but it does not establish that a treatment has improved fertility in the way patients ultimately need. The decision should turn on what the treatment might realistically add to an IVF plan—not on the promise implied by its name.
More follicles are not the same as better-quality eggs
Much of the interest in ovarian PRP centres on changes in ovarian reserve markers, including AMH and FSH, alongside the number of antral follicles seen on ultrasound. PRP may increase AMH, lower FSH and increase follicle numbers in some women. Not everyone responds, and these changes do not prove that the eggs obtained will have better developmental potential.
The hoped-for benefit is an increase in follicular recruitment: encouraging existing follicles to become available for stimulation. PRP cannot create new eggs. There is also no proof that it changes egg chromosomes or reliably improves egg quality.
For someone who produces very few eggs during IVF, obtaining a couple more could still matter. In women over 40, more eggs may increase the chance that one is chromosomally normal. But the possible benefit comes from having more opportunities, not from evidence that treatment has repaired age-related changes within an egg.
The same caution applies when IVF has produced poor fertilisation or embryos that stop developing. There is no randomised evidence proving that PRP or stem cells improve egg or embryo quality. Reports of a possible trend towards better blastocyst development remain unproven, so these treatments should not replace an investigation into other potential causes, including sperm-related factors.
Who might consider an experimental treatment?
These approaches are generally discussed with patients whose ovaries are producing few follicles or responding poorly to stimulation. That may include women with low AMH, women with premature ovarian insufficiency before 40, and those in perimenopause whose cycles have become irregular. The aim is usually to see whether a limited response can be improved enough to proceed with egg collection.
Having low AMH does not automatically mean PRP should come before IVF. For a younger patient planning to freeze eggs or start treatment, proceeding with stimulation first may be the more useful next step. If the response is poor, an experimental add-on can then be considered without having postponed the initial opportunity to collect eggs.
Age also changes the context of the decision. PRP appears to work better in younger women, although some older women may show improvements in hormone levels or follicle numbers. At age 45, however, the chances of pregnancy and live birth remain very low, and PRP has not been shown to increase them.
Early menopause needs a careful assessment rather than an automatic referral for ovarian injections. Investigations may include a karyotype and fragile X testing, because chromosomal abnormalities such as mosaicism can be involved. Understanding the cause is part of deciding whether an experimental procedure is appropriate.
For women who do not wish to move to egg donation, these treatments may be considered a last-resort attempt with their own eggs. That preference deserves an honest discussion rather than either a promise or a dismissal. The essential condition is understanding that treatment may produce no useful response and has not been proven to improve the chance of a live birth.
What happens during ovarian PRP?
PRP is prepared from a patient’s own blood. A small amount is drawn and centrifuged; the platelets are activated, and the resulting preparation is injected into the ovaries. The procedure is intended to deliver growth factors and cytokines that may influence the local ovarian environment.
The proposed effects include improved blood supply, formation of new vessels and a local inflammatory response that could help stimulate existing follicles. The ovarian puncture itself may also contribute to that response. These are proposed mechanisms, not proof that the procedure can turn back ovarian age.
PRP is the best-studied of the ovarian rejuvenation approaches discussed here, but the preparation is not uniform. The concentration of growth factors and cytokines can vary with the kit, preparation method and operator. That variation makes it difficult to assume that every treatment described as ovarian PRP delivers the same product.
More automated preparations, including Magellan PRP, aim to provide greater consistency and may cost more. They have been studied for less time, however, and have not been proven to increase live birth rates. A more concentrated or more expensive preparation should not be mistaken for one with better-established fertility outcomes.
Are stem cells a better option?
Stem cell treatment is a different procedure, not simply a stronger form of PRP. PRP delivers growth factors and cytokines, whereas stem cell-based treatment aims to deliver the cells themselves. Some studies suggest improvements in hormone profiles, but there is still no clear evidence that this translates into better live birth outcomes.
In the approach described in Athens, tissue is generally obtained through abdominal liposuction. It is mechanically processed into a preparation referred to as nano fat, a stromal vascular fraction, before being injected into the ovaries under ultrasound guidance. Laparoscopy may occasionally be needed when ultrasound access is difficult.
The extra steps make stem cell treatment more invasive and more expensive than PRP. It also has less evidence behind it. There is no randomised comparative study establishing that stem cells are better than PRP for improving follicle numbers, egg quality or the chance of a baby.
Combining stem cells with PRP adds another layer of uncertainty. The rationale is to try to stimulate the ovaries through different mechanisms, but the combined approach is less studied than either treatment alone. Controlled randomised human studies have not established its benefit, so combining procedures cannot currently be presented as a proven improvement.
Do not let an add-on treatment delay egg collection
Neither PRP nor stem cell treatment is expected to work immediately. Any response may emerge over 3 to 6 months, but that does not mean patients should automatically wait for that entire period before proceeding. Avoiding lost opportunities for stimulation is especially important for older patients.
A practical plan involves checking hormone levels and antral follicle count monthly after treatment. If a more favourable cycle appears, stimulation can proceed rather than waiting for a larger or more dramatic change. The purpose is to use a possible improvement, not to keep pursuing better test results indefinitely.
The timing should therefore be agreed before the procedure. Patients need to know when monitoring will begin, what would count as a useful response and when stimulation would go ahead. Without that plan, an experimental add-on risks becoming a reason to postpone the treatment intended to obtain eggs.
Repeated procedures introduce a further uncertainty. There is no established evidence that repeating PRP produces a significant additional benefit. A lack of response should prompt a review of the treatment plan rather than an assumption that more injections will eventually work.
What are the risks—and what should you ask?
PRP is generally well tolerated, and because it uses the patient’s own blood, allergic reactions are not expected. Nevertheless, ovarian injection carries procedural risks, including pain, spotting and infection. Using an autologous product does not remove the risks associated with placing a needle into the ovary.
Long-term safety is less certain. Patients have not been followed far enough into the future to fully establish the long-term ovarian effects of these procedures. This uncertainty is particularly relevant to stem cell treatments, which are less studied and also require tissue collection through liposuction.
PRP should not be offered as a routine part of IVF. It belongs in a research context, with informed consent that clearly identifies it as experimental. Before agreeing to either approach, patients can ask:
- What evidence supports the exact procedure being offered, particularly for live birth rather than hormone changes?
- How will this fit around stimulation without delaying egg collection?
- What are the procedural risks and the remaining long-term uncertainties?
- What happens if there is no response, and is there evidence for repeating treatment?
- What additional cost and invasiveness does this option involve?
The answers should make the limits of treatment clearer, not obscure them with technical language. A clinic should be able to distinguish a possible increase in follicle numbers from an unproven claim about better-quality eggs. It should also explain why an experimental procedure is being considered for that particular patient.
Final Thoughts
Ovarian PRP and stem cell treatments may help some women achieve a more favourable hormone profile or recruit additional follicles. PRP has been studied longer and is less invasive, while stem cell approaches remain more experimental. Neither has been proven to reverse egg ageing, improve egg or embryo quality, or increase live birth rates.
For patients determined to continue with their own eggs, considering an experimental option can be understandable. The most useful plan keeps expectations realistic, acknowledges uncertainty and protects the opportunity to proceed with stimulation. The goal is not a younger-looking hormone result—it is to pursue the best available chance of obtaining eggs without losing valuable time.
