Comparative Therapeutic Effects of Cytokine-Rich Serum and Platelet-Rich Plasma in a Rat Model of Ovarian Ischemia-Reperfusion Injury.

To evaluate and compare the protective effects of cytokine-rich serum (ACRS) and platelet-rich plasma (PRP) against ovarian ischemia-reperfusion (I/R) injury in a rat model of ovarian torsion and detorsion. Forty-two female Wistar albino rats were randomly allocated into control, PRP, ACRS, I/R, I/R + PRP, I/R+ACRS, and donor groups. Ovarian torsion was induced for two hours followed by detorsion. PRP or ACRS was administered following detorsion. Ovarian tissues were evaluated using histopathological assessment, follicle counting, and immunohistochemical analysis of anti-Müllerian hormone (AMH), cleaved Caspase-3, VEGFA, and α-SMA. Ischemia-reperfusion injury resulted in marked ovarian damage, characterized by increased follicular degeneration, congestion, hemorrhage, edema, stromal connective tissue changes, inflammatory cell infiltration, and elevated apoptotic activity. Both PRP and ACRS attenuated histopathological injury and apoptotic activity while improving follicular preservation. Compared with PRP, ACRS was associated with better preservation of primordial and tertiary follicles, fewer atretic follicles, higher AMH immunoreactivity, lower cleaved Caspase-3 immunoreactivity, and increased VEGFA immunoreactivity. No significant differences were observed in α-SMA immunoreactivity among groups. Both PRP and ACRS exert protective effects against ovarian I/R injury; however, ACRS was associated with more pronounced histological and molecular benefits. These findings suggest that ACRS may represent a promising biological approach in ischemic ovarian pathologies.