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Purpose <p>Poor ovarian response and primary ovarian insufficiency remain major challenges in assisted reproductive technologies. Recent advances propose mechanical approaches—such as in vitro activation, drug-free IVA, and whole ovarian laparoscopic incision (WOLI)—as well as biological strategies like platelet-rich plasma (PRP) injections to improve ovarian function. This study aims to evaluate the impact of WOLI and PRP on ovarian follicular activation, with a particular focus on the associated biomechanical alterations in the ovarian cortex.</p> Methods <p>Experimental pilot study includes six aged female Merino sheep. Group A underwent WOLI on one ovary, and group B received PRP injections. Contralateral ovaries served as controls. Laparoscopic bilateral oophorectomies were performed at 2, 4, and 6 months. Atomic force microscopy (AFM) measured ovarian cortical stiffness, and histological analysis assessed follicular activation. Analyses were performed by comparing the operated ovary to the contralateral, non-operated ovary.</p> Results <p>AFM measurements showed that in group A, ovarian stiffness significantly increased at 6&#xa0;months (8.683&#xa0;kPa vs. 5.551&#xa0;kPa; <i>p</i> &lt; 0.001), with no significant differences at 2 or 4&#xa0;months. In group B, stiffness increased significantly at 2&#xa0;months (11.177&#xa0;kPa vs. 6.590&#xa0;kPa; <i>p</i> &lt; 0.001), but not at 4 or 6&#xa0;months post-intervention. Growing follicle proportions differed between treated and control ovaries respectively, with activation at 2&#xa0;months (58.95% vs. 29.73%) in group A and 6&#xa0;months in group B (53.01% vs. 20.33%).</p> Conclusion <p>The study suggests that the activating effect on ovarian folliculogenesis of both the surgical procedure and PRP administration shows a different time course and that could be related to its effect on ovarian cortex mechanobiology.</p>

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Ovary laparoscopic incision and intraovarian platelet-rich plasma induce distinct cortical stiffness changes and follicular activation in aged sheep—a pilot study

  • 期刊论文

  • 发表日期：

    2026年1月10日

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  • Marta Méndez Justo,
  • Janisse Ferreri Dos Anjos,
  • Carolina Herranz-Diez,
  • Jordi Otero Diaz,
  • Jose Antonio Domínguez Arroyo,
  • Ignacio Santiago Álvarez Miguel,
  • Soledad Sanchez Mateos,
  • Josep Maria Calafell,
  • Salvadora Civico Vallejos,
  • Ester Parraga,
  • Ramon Farre,
  • Francisco Miguel Sanchez Gargallo,
  • Francesc Fabregues Gasol

摘要

Purpose

Poor ovarian response and primary ovarian insufficiency remain major challenges in assisted reproductive technologies. Recent advances propose mechanical approaches—such as in vitro activation, drug-free IVA, and whole ovarian laparoscopic incision (WOLI)—as well as biological strategies like platelet-rich plasma (PRP) injections to improve ovarian function. This study aims to evaluate the impact of WOLI and PRP on ovarian follicular activation, with a particular focus on the associated biomechanical alterations in the ovarian cortex.

Methods

Experimental pilot study includes six aged female Merino sheep. Group A underwent WOLI on one ovary, and group B received PRP injections. Contralateral ovaries served as controls. Laparoscopic bilateral oophorectomies were performed at 2, 4, and 6 months. Atomic force microscopy (AFM) measured ovarian cortical stiffness, and histological analysis assessed follicular activation. Analyses were performed by comparing the operated ovary to the contralateral, non-operated ovary.

Results

AFM measurements showed that in group A, ovarian stiffness significantly increased at 6 months (8.683 kPa vs. 5.551 kPa; p < 0.001), with no significant differences at 2 or 4 months. In group B, stiffness increased significantly at 2 months (11.177 kPa vs. 6.590 kPa; p < 0.001), but not at 4 or 6 months post-intervention. Growing follicle proportions differed between treated and control ovaries respectively, with activation at 2 months (58.95% vs. 29.73%) in group A and 6 months in group B (53.01% vs. 20.33%).

Conclusion

The study suggests that the activating effect on ovarian folliculogenesis of both the surgical procedure and PRP administration shows a different time course and that could be related to its effect on ovarian cortex mechanobiology.