Effects of autologous Platelet-Rich Plasma treatment on thin endometrium in patients undergoing frozen-thawed embryo transfer cycles Platelet-Rich Plasma as treatment for thin endometrium

Abstract

Objective
The objective of this study is to determine whether the treatment of a thin endometrium with autologous platelet-rich plasma (PRP) prior to an embryo transfer increases positive reproductive outcomes in cycles where implantation failure is attributable to a thin endometrium, during the endometrial preparation cycles.
Material and Methods
This is a cohort, prospective and interventional study, carried out in a private facility. Women between 32 and 45 years old were included, with a history of two or more failed IVF/ICSI (In vitro fertilization/Intracytoplasmic sperm injection) cycles and a thin endometrium (<7 mm), the cycles were with their own ovules or from donors not older than 28 years, with or without alterations in the seminal samples of their partners.
Twenty-five women were enrolled in this study, the patients were treated with an intrauterine infusion of autologous PRP 2 or 3 times during the menstrual cycle on days 8, 10 and 12 of endometrial preparation for their frozen-thawed embryo transfer (FET) cycle, and Embryo Transfer (ET) was performed 3 to 5 days after the final autologous PRP infusion. A total of 25 patients underwent FET.
Results
Of 25 patients included in this study, the mean endometrial thickness after PRP treatment was 8.6 mm. The average increase in endometrial thickness was 1.76 mm this difference was statistically significant when compared with the previous cycles for each patient, respectively. The results of the cycles with PRP infusion treatment were compared with the previous results obtained in the same group of patients. The implantation, clinical pregnancy, and live birth rates (LBR) in the PRP treatment cycle were 24.59, 56, and 48%, respectively. Implantation, clinical pregnancy, and LBR in the control cycle were 0%. Implantation, clinical pregnancy, and LBR were significantly higher in the PRP treatment cycle than in the control cycle. Age, BMI, number of embryos transferred, and number of good quality embryos transferred were not significantly different.

Conclusions
The present study revealed a noticeable improvement in endometrial thickness after the PRP treatment considering the history of the patients, however, more studies are needed to elucidate the molecular basis of the PRP action mechanism on the endometrium and to support the results obtained and generate more solid evidence on the beneficial effect of autologous PRP treatment on the thin endometrium.