A pilot study on effect of autologous platelet-rich plasma on refractory thin endometrium in frozen embryo transfer cycle

Abstract

Background: During assisted reproductive technology (ART) treatments, one of the most common reasons for cancellation of the cycle is thin endometrium. Refractory endometrium which doesn’t respond to standard medical therapies can be the aetiology of recurrent implantation failure. Thin endometrium remains an unsolved problem in the treatment of infertile women. Autologous PRP is known to help tissue regeneration. Aims: To evaluate the effect of intrauterine infusion of platelet-rich plasma in case of thin endometrium and its impact on endometrial thickness and clinical pregnancy rate. Materials and Methods: Our study was prospective randomised controlled trial done from 1st October 2018 to 1st April 2019 at Reproductive Biology & IVF Centre, Maulana Azad Medical College, New Delhi, India. Twenty- four women undergoing frozen embryo transfer with history of thin endometrium (less than 7 mm) with normal hysteroscopic examination were enrolled. Patients with uncorrected asherman syndrome, submucosal polyp, fibroid or congenital uterine anomaly were excluded from study. From day 2 of menses Tab estradiol valerate (tablet Estrabet, Abott India) was started in a dose of 6–8 mg/day. It was increased up to 12 mg/day gradually after reviewing endometrial thickness serially. Patients with thin endometrium on day 10/11 received PRP on day 11 and repeat dose after 48 hours if endometrial thickness was less than 7 mm. Frozen embryo transfer was done in patients who achieved endometrial thickness 7 mm or more. Results: The mean pre-treatment endometrial thickness was 4.68±0.96 mm, which significantly increased to 6.65±0.52 mm, post treatment (P < 0.05). Four patients out of 24 in our study could not achieve an optimal pattern of endometrium after treatment and embryo transfer was postponed. The positive beta human chorionic gonadotropin rate was 55%, and clinical pregnancy rate was 45% among them. Conclusion: PRP was found to play an effective role in thin endometrium.