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Objective: To conduct a systematic examination and meta-analysis of the most reliable data from experimental studies evaluating the efficacy of autologous platelet-rich plasma (PRP) on low ovarian reserve. Methods: A comprehensive search was performed utilizing pertinent search terms across electronic databases, including PubMed, Cochrane, and Google Scholar. We included studies that assigned infertile women with low ovarian reserve in experimental studies. Ovarian reserve parameters were measured before and after PRP injection into ovaries. The data of each study was retrieved and subsequently compiled. Results: Of 301 articles collected and reviewed, six studies were finally included in the meta-analysis. Following PRP injection, infertile women showed a non-significant increase in anti-Mullerian hormone (AMH) level (MD=0.10; 95% CI -0.04, 0.23), a significant increase in antral follicular count (AFC) (MD=1.88; 95% CI 0.47, 3.29), and a non-significant reduction in follicle-stimulating hormone (FSH) level (MD=-0.22; 95% CI -8.32, 7.87). Conclusions: Autologous PRP may increase AFC, but not AMH. Although it is found beneficial in enhancing ovarian reserve (AFC), further research with strong evidence is still required.

Objective: To identify the attitudes of infertile couples toward their surplus frozen embryos. Methods: This study was according to PRISMA-ScR as the guideline for scoping review. Studies that assessed the attitudes of patients or infertile couples who had surplus embryos were included. We conducted systematic searches in English studies from April 2011-April 2021 using 7 databases: PubMed, Science Direct, EBSCO, Scopus, the Cochrane Library, Sage Journals, and Google Scholar. Data were charted based on author, year of publication, country, purpose, data collection, key findings, and research focus/domain. Results: A total of 37 research articles were included in the analysis. Their attitudes encompassed: supporting the donation of the surplus embryos for both research and reproductive purposes, continuing to store the frozen embryos, and disposing of the surplus embryos. Conclusions: Most of the infertile patients support donating their surplus embryos for research and reproductive purposes.

Objective: To determine the barriers of joining in-vitro fertilization (IVF) programs among infertile couples in developing countries. Methods: This study assessed infertile couples and the barriers or associated factors resulting in delayed decision-making of joining IVF program by searching databases PubMed, ScienceDirect, EBSCO, ClinicalKey, and Cochrane Library from inception until December 31, 2021. Additional search strategies were snowballing literature search and citation tracking. Results: Eleven articles were included in the scoping review. The cost was the greatest barrier of joining IVF program. Limited access and lack of assisted reproductive technology centers, few qualified infertility trained staff, insufficient government support, low priority in government policy, along with sociocultural factors, such as religion and false beliefs or myths were also majorly considered to be associated obstacles. Conclusions: The main barrier associated with IVF program among infertile couples in developing countries is the high cost of the IVF services.

Context: Fertility preservation (FP) is necessary for cancer patients who develop infertility due to chemotherapy and radiotherapy. In Indonesia, many systematic steps and long-term continued actions must be taken to establish FP units since there has been an increasing incidence of cancer among people under 45 years old. Aims: This study aimed at a comprehensive evaluation on the awareness and practices of health-care providers (HCPs) toward FP. Settings and Design: This was a descriptive cross-sectional study. Subjects and Methods: A validated nationwide online survey was completed by 160 HCPs as a representative sample from 11 provinces in 2017 that provide medical care to cancer patients at hospitals or clinics. Statistical Analysis Used: Descriptive statistics, analysis of variance, logistic regression, and Pearson correlation tests were used for the statistical analysis. Results: Respondents were specialists (59.4%) and other HCPs (40.6%). Around 60% of the HCPs who performed cancer therapies already discussed the fertility issues with their patients. Meanwhile, the HCPs (60.7%) also tended not to consult and refer their patients to fertility experts (P < 0.05). However, those who discussed the risk of infertility with patients tended to consult with and refer them to a fertility consultant for further FP procedure as the follow-up for their discussions (odds ratio = 8.98, confidence interval 95%, P < 0.05). Conclusions: In Indonesia, FP awareness of the HCPs who performed cancer therapy was high. Nevertheless, attitudes to refer patients to fertility experts for possible FP management still need to be improved.