Autologous platelet-rich plasma to prevent a thin endometrium in patients undergoing clomiphene citrate therapy: a pilot prospective self-controlled trial

Abstract

Aim: This is a pilot prospective self-controlled trial study. It aimed to explore the efficacy of intrauterine infusion of autologous platelet-rich plasma (PRP) in infertile ladies as an adjuvant to clomiphene citrate (CC) in ladies with previous CC failure attributed to a thin endometrium (≤ 7 mm). Materials and Methods: This study included thirty anovulatory PCOS women with CC failure for 3 cycles with a thin endometrium (7 mm). All patients underwent ovarian stimulations for 2 cycles; control cycle (30 women received CC alone and one got pregnant) and study cycle (29 women received CC plus an intrauterine infusion of PRP). Main endpoints included the comparison of the endometrial thickness (ET) and endometrial vascularity pattern by power Doppler on the day of hCG injection between both treatment cycles. Results: There was a statistically significant increase in the endometrial thickness on the day of hCG injection with CC plus PRP compared to CC alone (8.98 ±1.31 vs, 5.8 ±1.2; p < 0.0001). There was a significant improvement in the endometrial blood flow with the use of PRP (p= 0.00004). The pregnancy rate is significantly higher in the PRP cycles compared to control cycles (7 pregnancies (24.14%) vs. one pregnancy (3.3%) respectively; p = 0.0257). Conclusion: Intrauterine infusion PRP seems to be a promising adjuvant to increase endometrial thickness and endometrial blood flow with subsequent improvement in clinical pregnancy rate in ladies with CC failure due to thin endometrium.

Obesity attenuates the beneficial effect of an intrauterine infusion of autologous platelet-rich plasma during in vitro fertilization

“…This is because multiple intra-articular injections of PRP in damaged tissues are more effective than a single application, as seen for knee osteoarthritis [37,38]. This is supported by other studies where the clinical pregnancy rate was higher when at least two doses were applied over a single dose [21,39,40]. Therefore, it is posited that a multi-dose treatment should be considered for future studies.…”

“…For this self-controlled study, the sample size was calculated using the SCCS package for R Am J Transl Res 2024;16(3):838-854 [19,20]. The inputs were based on the results from a similar study [21], in which the clinical pregnancy rate for the control and the treated group was 3.3% and 24.1%, respectively. With an alpha = 0.05 and power = 0.95, the calculated sample size was 15 subjects.…”