Autologous platelet-rich plasma infusion improves clinical pregnancy rate in frozen embryo transfer cycles for women with thin endometrium

Abstract

Background:Adequate thickness of the endometrium has been well recognized as a critical factor for embryo implantation. This was a prospective cohort study to investigate the benefits of platelet-rich plasma (PRP) for women with thin endometrium who received frozen embryo transfer (FET) program in a larger number of patients and explore the underlying mechanism.Methods:In this study, we investigated the effects of PRP in women with thin endometrium in FET program. 64 patients with thin endometrium (<7 mm) were recruited. PRP intrauterine infusion was given in PRP group during hormone replacement therapy (HRT) cycle in FET cycles.Results:After PRP infusion, the endometrium thickness in PRP group was 7.65 ± 0.22 mm, which was significantly thicker than that in control group (6.52 ± 0.31 mm) (P <.05). Furthermore, PRP group had lower cycle cancellation rate when compared to control group (19.05% vs. 41.18%, P <.01). The implantation rate and clinical pregnancy rate in PRP group were significantly higher than those in control group (27.94% vs 11.67%, P <.05; 44.12% vs 20%, P <.05, respectively). PRP blood contained 4 folds higher platelets and significantly greater amounts of growth factors including platelet-derived growth factor (PDGF)-AB, PDGF-BB, and transforming growth factor (TGF)-β than peripheral blood (P <.01).Conclusions:PRP plays a positive role in promoting endometrium proliferation, improving embryo implantation rate and clinical pregnancy rate for women with thin endometrium in FET cycles.

Autologous Platelet-Rich Plasma Infusion to Improve Pregnancy Outcome in Suboptimal Endometrium: A Review

“…In the pilot study, Estradiol Valerate (E 2 V) started at 3 mg/d on day 3 of menses and increased every 4 days up to a max of 12 mg/d; and in the cohort s t udy, E 2 V started at 6 mg/d and subsequently increased to 12 mg/d [18,25]. The pilot study included five patients suffering from chronically non-responsive thin endometrium (5.9-6.6 mm) who underwent PRP infusion on the 10th day of HRT and lining was measured via transvaginal ultrasound.…”

“…Nazari and coworkers performed a follow-up study utilizing a double-blinded trial in which 30 patients underwent PRP infusion, prepared in the same manner as the initial pilot study [19], and 30 patients underwent placebo PRP infusions [24]. Chang et al performed a secondary study as well, involving a larger cohort of patients compared against a control group, and performed PRP collection as previously reported [18,25]. All studies transfused the PRP into the endometrium using an IUI catheter, and then repeated intravaginal ultrasound 48 hours later to measure endometrial growth; patients who did not reach the desired lining thickness (>7 mm deemed adequate in all studies) were then treated with a second round of PRP infusion [18][19][20][21][22][23][24][25].…”

“…Of 346 patients, 313 underwent embryo transfer at either cleavage or blastocyst stage. The remaining 33 patients dropped out of the studies prior to embryo transfer due to persistently poor endometrial development [18][19][20][21][22][23][24][25].…”

Cellular therapies for the endometrium: An update

“…Moreover, eSC eVs increase blastomere count and VEGF release in co‐culture with murine embryos . One approach to this has been the use of platelet‐rich plasma in clinical trials for intrauterine infusion . These trials reported increased endometrial thickness and enhanced implantation and pregnancy rates with platelet‐rich plasma treatment.…”

“…42 One approach to this has been the use of platelet-rich plasma in clinical trials for intrauterine infusion. [43][44][45] These trials reported increased endometrial thickness and enhanced implantation and pregnancy rates with platelet-rich plasma treatment. Platelet-rich plasma is known to contain both platelet-derived eVs and a plethora of pro-healing factors, including platelet-derived growth factor alpha, which has been demonstrated in many contexts to be beneficial in tissue repair and regeneration.…”