The Effectiveness of Intra-Uterine Platelet Rich Plasma Infusion for Improving Endometrial Thickness and Pregnancy Outcomes: A Pilot Study Analysis

Abstract

Background: Platelet rich plasma (PRP) is well researched and utilized in many medical fields to increase angiogenesis, tissue healing and regeneration a . Recent studies have reported that intra-uterine PRP infusions when used during frozen embryo transfer (FET) cycles, can similarly affect endometrial proliferation, resulting in decreased cycle cancellation rates and improved endometrial thickness and pregnancy outcomes in women with thin linings b , c Aim: To establish if intra-uterine PRP infusions can increase endometrial thickness and improve pregnancy rates in women with a history of thin endometrial lining. Method: An analysis of all PRP infusions and their FET cycles undertaken at Ballarat IVF between November 2020 and May 2021 was performed. Patients with a history of thin endometrial lining were offered a PRP infusion from day 6 of their cycle, followed by a second infusion 2-3 days later. Endometrial thickness was measured by ultrasound prior to PRP infusion, post infusion #1/prior to PRP infusion #2, and post PRP infusions, and pregnancy outcomes collected. Results: Thirty patients were offered PRP infusions prior to their FET cycle and all 30 patients received one infusion of PRP. Twenty-six patients went on to receive a 2nd PRP infusion. Twenty-five patients had an FET, only one cycle was cancelled due to poor endometrial thickness. Average Endometrial thickness increased by 0.8mm after each PRP infusion; from 6.2mm prior to PRP infusion, to 7.0mm prior to PRP infusion #2, to 7.8mm post PRP infusions. Clinical pregnancy rates and ongoing pregnancy rates were 48%* and 24%* respectively (*two scans pending: anticipated rates 48% and 28% respectively). Conclusion: Intra-uterine Platelet Rich Plasma infusions prior to a FET appear to offer a safe method to increase endometrial lining in women with a history of thin endometrium, allowing these cycles to proceed to an embryo transfer. Clinical pregnancy rates are increased compared to women who have no history of thin endometrial lining. Despite increased implantation, ongoing pregnancy rates (defined by a fetal heart) are decreased compared to women with no history of a thin lining. A longer-term study on a larger number of patients is required to confirm the effectiveness of this technique on live birth rates.