Use of Intra-uterine Injection of Platelet-rich Plasma (PRP) for Endometrial Receptivity and Thickness: a Literature Review of the Mechanisms of Action

Intrauterine interventions for women with two or more implantation failures: A systematic review and network meta-analysis

“…PRP contains numerous molecules such as cytokines, chemokines, cell-adhesion molecules and growth factors ( 31 ), which are essential in endometrial receptivity and embryo implantation ( 32 ), and dysregulation of these pro-implantation molecules will result in implantation failure ( 33 ). It has been hypothesized that intrauterine infusion of PRP might improve endometrial receptivity and promote embryo implantation by modulating the expression of cytokines such as interleukin-1β(IL-1β), IL-6, and IL-8, increasing the expression of estrogen and progesterone receptor, and promoting endometrial cell proliferation ( 34 ).…”

Implantation of embryos. The way for the improvement of the cumulative life birth rate (CLBR) in the assisted reproductive technology (ART)

“…There are also suggestion of using, as an alternative strategy in women with thin endometrium and recurrent implantation failure, intrauterine infusion of autologous platelet-rich plasma (PRP) in assisted reproductive technology (ART) leads to better results. For better results the authors stated that these findings need further confirmation in large prospective and high quality controlled, randomised trials [41]. Finally, the mode of transferring also can influence the effectiveness of infertility treatment.…”

Endometrial thickness: How thin is too thin?

“…Platelet-rich plasma is a concentrate derived from PRO: A thin endometrial stripe needs to be improved (continued) CON: A thin endometrial stripe is not always detrimental (continued) reproductive medicine is less established but, nonetheless, intriguing. In principle, the cytokines and growth factors found in platelet a-granules allow PRP to promote tissue regeneration at the cellular level (39). It could then be surmised that if the root cause of refractory endometrium is endometrial injury or damage secondary to a procedure or disease process (i.e., dilation and curettage, endometritis, intrauterine adhesions, etc.…”

“…What is more is that the cost of PRP therapy for other medical conditions (arthritis and alopecia) can range from $500 to $2,500, and it is unlikely that PRP used in the IVF setting would be any more affordable. Taken all together, although a reasonable amount of data exists, drawing final conclusions about the potential benefits of PRP for patients with refractory endometrium from the current literature is difficult because of poor study design (the lack of randomization and blinding), the lack of treatment standardization (differences in preparation and infusion protocols), and the inclusion of multiple infertility diseases in trials (recurrent implantation failure, recurrent pregnancy loss, and refractory endometrium) (39,46). At this juncture, the intrauterine infusion of PRP for refractory endometrium is at best at the experimental stage, and clinicians should exercise caution the centrifugation of autologous blood to remove red blood cells and is theorized to have an effect on endometrial regeneration and the regulation of immunologic mediators (100).…”