Can autologous platelet rich plasma expand endometrial thickness and improve pregnancy rate during frozen-thawed embryo transfer cycle? A randomized clinical trial

Abstract

Objective: One of the important aspects involved in achieving optimal outcomes after assisted reproductive treatment (ART) is the endometrium. Some cycles are cancelled due to inadequate endometrial growth in ART. In this clinical trial, we evaluated the effectiveness of platelet-rich plasma (PRP) in the treatment of thin endometrium.

Materials and methods: In this randomized clinical trial, 83 women with poor endometrial response to standard hormone replacement therapy (HRT) (endometrium thickness < 7 mm) in the 13th day of the cycle in a frozen-thawed embryo transfer (FET) were entered in two groups. In the PRP group (n = 40), in addition to HRT, 0.5-1 cc of PRP was infused into the uterine cavity on the 13th day of HRT cycle. The control group (n = 43) was only received HRT. If endometrial thickness failed to increase after 48 h, PRP infusion was repeated in the same cycle. When the endometrium thickness reached ≥7 mm, embryo transfer was done. Finally, endometrial thickness, chemical, clinical, and ongoing pregnancy rates were compared between two groups.

Results: Endometrial thickness increased significantly to 8.67 ± 0.64 in PRP group than in controls (p = 0.001). This increase was higher in women who conceived in PRP group (p value: 0.031). The implantation rate and per-cycle clinical pregnancy rate were significantly higher in PRP group (p = 0.002 and 0.044, respectively (p = 0.002).

Conclusion: PRP may be effective in improving the endometrial growth, and possibly pregnancy outcomes in women with a thin endometrium.

Keywords: Platelet-rich plasma; Pregnancy rate; Thin endometrium.