The success rate in Assisted Reproductive Technologies (IVF) has improved significantly. Still, some cases like decreased ovarian reserve and poor uterine lining remain a challenge and often require alternative options like egg donation or gestational surrogacy. The use of PRP for growth and repair in orthopedics, cardiothoracic surgery, plastic surgery, dermatology, dentistry, and diabetic wound healing has been promising and has now expanded into reproductive medicine. Since several studies have evaluated autologous platelet-rich plasma (PRP) and its effects on infertility.
Autologous PRP is obtained through the collection of an individual’s own blood via peripheral venipuncture that is then centrifuged to remove red blood cells from the sample. The purpose of this is to have a concentrated sample of platelets that contain a 5- to 10-fold higher concentration of growth factors that get released by activated platelets. The numerous growth factors and cytokines PRP releases when injected into various organs like the uterus or ovaries have shown to play a role in tissue regeneration and new blood vessel formation angiogenesis. It is theorized that these effects can improve pregnancy rates in certain difficult cases.
A thin endometrium (defined as < 7mm) is suboptimal for embryo implantation and is associated with poor pregnancy outcomes. There are a number of therapies currently being used to improve the chances of implantation such as extended estrogen therapy, low dose aspirin, vitamin E, vaginal sildenafil, and pentoxifylline with various efficacies.
Intrauterine autologous PRP in women with thin lining seems to show promise with some studies showing a significant increase in uterine thickness and clinical pregnancy rates after intrauterine infusion of PRP 48 hours prior to frozen embryo transfer in women with previous poor linings.
Some PRP studies have also suggested an increase in AMH levels, number of antral follicles and improved pregnancy rates in women with a history of poor egg yield and poor embryo quality who received intra-ovarian injections of PRP 2 months prior to IVF. AMH levels and Antral follicular counts are repeated on days 2-3 of the next menstrual period to evaluate the effects of PRP Intraovarian therapy. Unfortunately, most of these studies are discouraging and did not achieve clinical significance. Therefore, while it’s a novel alternative, it remains to be seen whether PRP injections have any value in menopausal women.
In conclusion, autologous PRP is a novel alternative approach to the treatment and management of certain refractory infertility issues. While PRP has been used safely and effectively in multiple conditions, studies have also suggested promising results in women with thin endometrial lining, as well as a possible improvement in ovarian reserve. For these women, PRP offers a low-cost, easily obtained, safe therapeutic option that may be worth trying. Additional research needs to be done using larger-scale randomized controlled trials with larger sample sizes to demonstrate the utility of autologous PRP in reproductive medicine. Until we have definitive data, PRP use should be considered experimental.
At CRE, we are proud to have been a part of so many difficult infertility success stories. We hope to have the chance to be a part of yours! Please call us at 972-566-6686 or click here to make an appointment to meet with Dr. Saleh or Dr. Collins for a consultation.