Effects of intrauterine autologous platelet-rich plasma infusions on outcomes in women with repetitive in vitro fertilization failures: a prospective randomized study

Abstract

Evaluation of the e fect of platelet-rich plasma (PRP) containing platelet-derived growth factor on in vitro fertilization (IVF) failure patients. Methods: In this clinical trial, 80 eligible patients (infertile women with at least two IVF failures) were randomly assigned into two groups, including patients who received an intrauterine infusion of PRP (n: 40) and controls (n: 40). Before PRP therapy, standard hormone replacement therapy was performed for all patients to endometrial thickness preparation. A ter sonographic assessment of endometrium, PRP was injected into all patients' endometrium whether they had an appropriate endometrial thickness or not. Then, the embryo transferring was done through IVF. Eventually, the consequences of fertility, embryo implantation, and pregnancy were evaluated. Data analysis was performed using SPSS version 22. Results: The rate of successful IVF [6 (15%)], pregnancy rate [5 (12.5%)], and live birth [5 (12.5%)] were relatively higher in patients undergoing PRP therapy compared with controls [2 (5%), 1 (2.5%) and 0, respectively]. However, their statistical di ference was not significant between the two groups (P > 0.05). Conclusion: Our findings suggest that endometrial injection of platelet-rich plasma for IVF failure patients did not significantly improve the IVF process, pregnancy, and live birth rates.

Efficacy of Platelet-Rich Plasma in Women with a History of Embryo Transfer Failure: A Systematic Review and Meta-Analysis with Trial Sequential Analysis

“…Hormone replacement therapy (HRT) was applied to all participants, regardless the experimental group. Nine studies infused ≤1 mL PRP [ 11 , 12 , 31 , 32 , 37 , 42 , 44 , 45 , 46 ], and two studies administered >1 mL [ 38 , 47 ], whereas one trial did not provide this information [ 43 ]. None of the studies reported on the activation of the PRP before application.…”

“…Ten studies evaluated clinical pregnancy in 933 women with RIF [ 31 , 32 , 37 , 38 , 44 , 45 , 46 , 47 ] and 143 women with TE [ 11 , 12 ]. Clinical pregnancy was interpreted as the presence of fetal heartbeat in transvaginal ultrasound 5–6 weeks after embryo transfer in six studies [ 11 , 12 , 31 , 32 , 45 , 46 ].…”

“…Other study defined it as the presence of an embryonic sac at 5–6 weeks gestation [ 44 ]. Two publications did not define the term [ 38 , 47 ].…”

“…Five studies analyzed implantation rate after PRP treatment [ 12 , 37 , 38 , 46 , 47 ]. These studies were composed of a total of 401 infertile women who had experienced RIF (four studies) or TE (one study).…”

“…Interestingly, favorable outcomes have also been reported in patients with low ovarian reserve [ 35 ], premature ovarian insufficiency [ 36 ] and post-menopausal women [ 36 ] after intraovarian PRP administration. By contrast, some researchers observed no benefit for embryo implantation, pregnancy rate or live birth rate when PRP was administered in the uterus [ 37 , 38 ]. The aim of our study was to investigate whether intrauterine PRP infusion can improve embryo implantation and its potential for enhancing pregnancy outcomes in women with a history of ART failure, through an analysis of the available RCTs.…”