Autologous Platelet-Rich Plasma Improves Pregnancy Outcomes of Patients with Thin Endometrium Regardless Endometrial Thickening: Multicenter Retrospective Study with Elimination of Embryonic Confounders

Abstract

Objective: To determine whether endometrial thickening is an important factor for pregnancy outcomes in platelet-rich plasma (PRP) treatment for patients with thin endometrium. Methods: Data from the registry database of the Japan Gynecologic PRP Study Group from April 2019 to October 2021 were analyzed retrospectively. A total of 208 patients who underwent single blastocyst transfer (SBT) after PRP due to thin endometrium (¡8 mm) in their previous cycle were included in the study. Their pregnancy outcomes were compared with their own historical data before PRP infusion. The same patient group was then divided into 136 patients whose endometrium thickened after PRP and 72 patients whose endometrium did not, and the pregnancy outcomes of the two groups were compared. Furthermore, to eliminate embryonic confounding, 28 patients who had single euploid blastocyst transfer (SEBT) with preimplantation genetic testing for aneuploidy (PGT-A) were selected from the same patient group and divided into two groups of 22 patients whose endometrium thickened and 6 patients whose endometrium did not, and the pregnancy outcomes were compared in the same method. Results: After PRP administration, the clinical pregnancy rate, live birth rate, and miscarriage rate were all significantly improved compared with the historical controls (34.1 vs 20.0, [Formula: see text]; 22.6 vs 3.9, [Formula: see text]; 33.8 vs 73.4, [Formula: see text]). There were no statistically significant differences in the respective rates between the “thickened endometrium” group and the “unthickened endometrium” group in SBT group (36.0 vs [Formula: see text], [Formula: see text]; 25.7 vs [Formula: see text], [Formula: see text]; 28.5 vs [Formula: see text], [Formula: see text], respectively). Likewise, in the SEBT with PGT-A group, there were no statistically significant differences in results between the two groups (36.4 vs [Formula: see text], [Formula: see text]; 36.4 vs [Formula: see text], [Formula: see text]; 0 vs [Formula: see text], respectively). Conclusions: PRP administration to patients with thin endometrium improves pregnancy outcomes even when endometrial thickening is not achieved.