Investigating the effectiveness of autologous Platelet-Rich Plasma and Condition Medium of mesenchymal stem cells derived from the umbilical cord on the serum level of Anti Mullerian Hormone in infertile women with Diminished Ovarian Reserve

Investigating the effectiveness of autologous Platelet-Rich Plasma (PRP) and Condition Medium of mesenchymal stem cells derived from the umbilical cord on the serum level of Anti Mullerian Hormone (AMH)

Clinical trial with a control group, with parallel groups, no blinding, randomized, phase1,2 on 44 patients.

1. Patient identification 2. Preparation of umbilical cord from a newborn in Imam Khomeini Hospital, Sari 3. Preparation of Condition Medium of mesenchymal stem cells derived from the umbilical cord in the clean room of Sina Mehr Fajr Laboratory, Sari 4. Preparation of PRP in Imam Khomeini Hospital, Sari 5. Injection into the ovaries in the operating room of Imam Khomeini Hospital, Sari 6. Examination of serum AMH and AFC levels of patients before injection and 2, 6 and 14 weeks after injection

Inclusion criteria: Women between 20 and 45 years of age, infertility for more than one year, having poor or diminished ovarian reserve, and one of the poor ovarian response criteria, which are: Total AFC in both ovaries 7 or less on vaginal ultrasound, AMH less than 1.1 ng/ml, history of IVF with 3 or less eggs, signing informed consent form. Exclusion criteria: Pregnancy, history of IgA deficiency or currently, surgery leading to pelvic adhesions, taking anticoagulant drugs, mental illness with drug dependence, chronic malignancies or chronic pelvic pain, severe male factor infertility, drug addiction, endometriosis and abnormal uterine shape observed on hysterosalpingography, failure to sign the informed consent form.

4 intervention groups: One group is injected with only autologous PRP, the other group with only Condition Medium, the next group with Condition Medium and PRP concurrently, and no injection for the control group.

Anti Mullerian Hormone, Antral Follicle Count

To allocate samples to each group, the random block method will be used. For this purpose, patients will receive numbers 1 to 44 according to their arrival. The randomization unit will be individual and by number with blocks of 4 people. The selection of the type of group for each individual will be done through the statistical software 2 allocation random. To create a random sequence, the software will generate codes A, B, C, D, and each code will be considered for one group. Finally, the codes will be placed in a sealed envelope and the number of each patient will be written on the envelope. In the order of each patient's arrival, the doctor will open the envelope and apply the desired treatment.