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

Abstract

Assisted reproductive technology (ART) is used to enhance pregnancy in infertile women. In this technique, the eggs are removed from the ovary and fertilized and injected with sperm to make embryos. Unfortunately, embryo implantation failures still occur in many of these women. Platelet-rich plasma (PRP) therapies use a patient’s own platelets to promote tissue healing and growth, including endometrium. The growth factors provided by the platelets play a criterial role on the regenerative ability of PRP. In the last years, PRP treatments have been gaining a lot of popularity to treat women with repeated ART failures. In this study, we collected and summarized all information published in the scientific literature to assess the evidence of the PRP effect on pregnancy. We only considered randomized controlled trials (RCT), a type of study designed to be unbiased and considered at the highest level of evidence. Our analysis indicates that PRP therapies might be an effective treatment in cases of poor responsiveness to conventional ART. However, additional studies (well-designed) are necessary to confirm this beneficial effect of PRP.

Autologous Platelet-Rich Plasma (PRP) Efficacy on Endometrial Thickness and Infertility: A Single-Centre Experience from Romania

“…Intrauterine adhesions are a major complication that will cause thin endometrium. In new studies, the use of the PRP treatment after hysteroscopic adhesiolysis could decrease the intrauterine adhesion forming and improve the menstrual cycle and hypothetically the endometrial thickness and receptivity [ 45 , 46 , 47 , 48 ]. Researchers and clinicians have encountered difficulty in creating a potent therapeutic approach.…”

Not all platelet-rich plasma are created equal

“…Emerging evidence suggests the potential benefits of PRPs in treating refractory endometrium and RIF, particularly in women with poor prognoses [45]. Recent meta-analyses and systematic reviews have shed light on the positive impact of PRPs on the improvement of the endometrial environment and RIF [46 ▪ ,47 ▪ ,48].…”

Follicle development and its prediction in patients with primary ovarian insufficiency: Possible treatments and markers to maximize the ability to conceive with residual follicles

“…PRP therapy is a treatment that involves the use of a patient's own blood, contains high concentration of platelets, to promote tissue regeneration 49 . In the field of assisted reproductive medicine, there have been a number of reports of intrauterine administration in patients with repeated implantation failure and thin endometrium 50–52 . Recent studies have shown that intraovarian injections of autologous PRP can enhance ovarian folliculogenesis 53,54 …”

“…49 In the field of assisted reproductive medicine, there have been a number of reports of intrauterine administration in patients with repeated implantation failure and thin endometrium. [50][51][52] Recent studies have shown that intraovarian injections of autologous PRP can enhance ovarian folliculogenesis. 53,54 Cakiroglu et al initiated transvaginal PRP therapy in 311 patients with POI.…”