First live births after adipose-derived stem cells and platelet-rich plasma intraovarian administration

This report describes two women aged 45 and older who achieved live births following intraovarian administration of a novel combination of mechanically processed adipose nanofat rich in adipose-derived stem cells (ADSCs) and autologous platelet-rich plasma (PRP). Both patients had a history of prolonged infertility and multiple failed assisted reproductive technology cycles with in vitro fertilization (IVF). Case 1, a 46-year-old with diminished ovarian reserve and prior miscarriage, underwent adipose-PRP treatment after unsuccessful minimal stimulation IVF. Six months later, she conceived naturally and delivered a healthy infant at age 47. Case 2, a 45-year-old with endometriosis and multiple failed IVF attempts, conceived via frozen embryo transfer of her only euploid embryo produced three months after adipose-PRP treatment, resulting in the birth of a healthy infant. The combination approach was developed to comply with U.S. FDA minimal manipulation guidelines, avoiding enzymatic processing of adipose tissue. This report is, to our knowledge, the first to document natural conception in women with age over 45 following combined adipose nanofat ADSCs and PRP intraovarian injection, and among the few to describe live births at this age using autologous oocytes after such therapy. These findings suggest that adipose-PRP treatment may offer a promising regenerative option for women with extremely diminished ovarian reserve who desire genetically related offspring, though controlled studies are required to confirm long term safety, efficacy, and appropriate patient selection.