Experience with intrauterine application of platelet-rich plasma in women with recurrent implantation failure

Czech version

Authors: P. Mrvková; V. Balogová; H. Višňová; R. Hüttelová
Authors‘ workplace: IVF CUBE, Praha
Published in: Ceska Gynekol 2026; 91(4): 336-340
Category: Case Report
doi: https://doi.org/10.48095/cccg2026336

Overview

Introduction: Intrauterine administration of platelet-rich plasma (PRP) is a technique currently under intensive investigation. PRP therapy has the potential to play a complementary role in treatment protocols for women with a thin endometrium or a history of recurrent implantation failure (RIF). The principle of PRP is based on the release of multiple biologically active factors (e. g., cytokines, growth factors) following administration, which initiate reparative processes such as the synthesis of new connective tissue or revascularization. A major advantage of PRP therapy is its favorable safety profile, as no serious adverse effects have been reported to date. In the following study, we summarize our clinical experience with intrauterine PRP administration at our IVF center. The aim of this study was to evaluate the effect of PRP on the clinical pregnancy rate in women with recurrent implantation failure. Materials and methods: A retrospective data analysis was performed. Between January 2021 and December 2024, intrauterine PRP was administered to 45 women with a history of recurrent implantation failure. PRP was applied intrauterinely via a catheter with a volume of 0.5–1 mL using two different protocols. Protocol A consisted of a single intrauterine PRP administration performed 2–5 days prior to embryo transfer. Protocol B included two administrations: the first on days 21–23 of the preceding cycle and the second on days 7–10 of the preparation cycle. The control group comprised of patients with RIF who underwent treatment at our clinic between January 2015 and December 2018 using a standard frozen embryo transfer protocol without PRP administration. Results: Among the 45 women with RIF treated with PRP, clinical pregnancy was confirmed by ultrasound in 23 patients (51.1%). In the control group of 35 women, 10 clinical pregnancies were achieved (28.6%). Statistical analysis using a Pearson’s Chi-square test demonstrated a P-value of 0.042, indicating statistical significance. Our findings therefore suggest that intrauterine PRP administration in patients with RIF is associated with a significantly higher clinical pregnancy rate compared to the standard protocol without PRP. These results indicate a potential beneficial effect of this adjunctive therapy on endometrial receptivity.

Keywords:

growth factors – clinical pregnancy – platelet-rich plasma – recurrent implantation failure

Sources

1. Ma J, Gao W, Li D. Recurrent implantation failure: a comprehensive summary from etiology to treatment. Front Endocrinol (Lausanne) 2023; 13 : 1061766. doi: 10.3389/fendo.2022.1061766.

2. Qi Y, Qi J, Sun Y. Platelet-rich plasma as a potential new strategy in the endometrium treatment in assisted reproductive technology. Front Endocrinol (Lausanne) 2021; 12 : 707584. doi: 10.3389/fendo.2021.707584.

3. Craciunas L, Gallos I, Chu J et al. Conventional and modern markers of endometrial receptivity: a systematic review and meta-analysis. Hum Reprod Update 2019; 25 (2): 202–223. doi: 10.1093/humupd/dmy044.

4. Cicinelli E, Matteo M, Tinelli R et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Hum Reprod 2015; 30 (2): 323–330. doi: 10.1093/humrep/deu292.

5. Wu D, Kimura F, Zheng L et al. Chronic endometritis modifies decidualization in human endometrial stromal cells. Reprod Biol Endocrinol 2017; 15 (1): 16. doi: 10.1186/s12958-017-0233-x.

6. Kitaya K, Matsubayashi H, Takaya Y et al. Live birth rate following oral antibiotic treatment for chronic endometritis in infertile women with repeated implantation failure. Am J Reprod Immunol 2017; 78 (5). e12719. doi: 10.1111/aji.12719.

7. Bos-Mikich A, Ferreira MO, de Oliveira R et al. Platelet-rich plasma or blood-derived products to improve endometrial receptivity? J Assist Reprod Genet 2019; 36 (4): 613–620. doi: 10.1007/s10815-018-1386-z.

8. Bos-Mikich A, de Oliveira R, Frantz N. Platelet-rich plasma therapy and reproductive medicine. J Assist Reprod Genet 2018; 35 (5): 753–756. doi: 10.1007/s10815-018-1159-8.

9. Aghajanova L, Houshdaran S, Balayan S et al. In vitro evidence that platelet-rich plasma stimulates cellular processes involved in endometrial regeneration. J Assist Reprod Genet 2018; 35 (5): 757–770. doi: 10.1007/s10815-018-1130-8.

10. Wang X, Liu L, Mou S et al. Investigation of platelet-rich plasma in increasing proliferation and migration of endometrial mesenchymal stem cells and improving pregnancy outcome of patients with thin endometrium. J Cell Biochem 2019; 120 (5): 7403–7411. doi: 10.1002/jcb.28014.

11. Maleki-Hajiagha A, Razavi M, Rouholamin S et al. Intrauterine infusion of autologous platelet-rich plasma in women undergoing assisted reproduction: a systematic review and meta-analysis. J Reprod Immunol 2020; 137 : 103078. doi: 10.1016/j.jri.2019.103078.

12. Kim JH, Park M, Paek JY et al. Intrauterine infusion of human platelet-rich plasma improves endometrial regeneration and pregnancy outcomes in a murine model of Asherman’s syndrome. Front Physiol 2020; 11 : 105. doi: 10.3389/fphys.2020.00105.

13. Zabrodina YV, Boyarsky Y, Akhmedyanova GU et al. Effect of platelet-rich auto plasma on endometrial thickness and receptor sensitivity to estrogen and progesterone. Ceska Gynekol 2024; 89 (3): 203–209. doi: 10.48095/cccg2024203.