Effect of Intrauterine Autologous Platelet-Rich Plasma on Pregnancy outcomes in Women with Repeated Implantation Failure Undergoing Assisted Reproductive Technology at a Fertility Centre in Sub-Saharan Africa: A Randomized Control Trial
Keywords:
Repeated Implantation Failure, Platelet-rich plasma, Chemical pregnancy rate, Clinical pregnancy rateAbstract
Background: Repeated Implantation Failure (RIF) is generally defined as the failure to achieve a clinical pregnancy
after the transfer of multiple, high-quality embryos across a minimum of three fresh or frozen in vitro fertilization (IVF)
cycles. RIF remains a challenging problem in IVF particularly among women who have experienced transfer of embryos
(fresh or frozen) considered to have reasonable implantation potential without achieving a pregnancy, AIM: This study
aimed to determine the impact of intrauterine infusion of platelet-rich plasma (PRP) in improvement of pregnancy
outcomes in RIF patients undergoing frozen embryo transfer (FET) METHODS: Patients with a history of RIF
undergoing FET were assessed for eligibility. A total of 100 eligible patients were recruited and randomized into 2
groups: control group (embryo transfer with standard endometrial preparation with oestradiol and adjuvant therapy other
than PRP) and intervention group (embryo transfer with standard endometrial preparation with oestradiol, adjuvant
therapy and PRP infusion). The intervention group received an intrauterine infusion of 0.4 ml of PRP on day 7th and day
12th of oestradiol valerate administration and on the day of progesterone supplementation. RESULTS: There were no
statistically significant differences in socio-demographic variables between the groups. There was statistically
significant difference in mean endometrial thickness at embryo transfer between the groups. (8.29 ± 0.87 vs 6.70 ± 0.51).
The differences in chemical pregnancy rates (62% vs 30%) and clinical pregnancy rates (48% vs 20%) were statistically
significant between the groups. However, the difference in the miscarriage rates were not statistically significant in the
groups. There were no side effects recorded. CONCLUSION: Our findings demonstrate the effectiveness and safety of
intrauterine infusion of PRP in improving pregnancy outcomes in RIF patients undergoing FET.
References
Bakhsh AS, Maleki N, Sadeghi MR, SadeghiTabar
A, Tavakoli M, Zafardoust S. et., al. Effects of
Autologous Platelet-Rich Plasma in women with
repeated implantation failure undergoing assisted
reproduction. JBRA Assist Reprod. 2022. 17; 26 (1):
84-87.
2. Shalma NM, Salamah HM, Alsawareah A,
Shaarawy AS, Mohamed MR, Manirambona E, et al.
The efficacy of intrauterine infusion of platelet rich
plasma in women undergoing assisted reproduction:
a systematic review and meta-analysis. BMC
Pregnancy Childbirth. 2023. 8; 23 (1): 843.
3. Craciunas L, Gallos I, Chu J, Bourne T, Quenby S,
Brosens JJ et al. Conventional and modern markers
of endometrial receptivity: a systematic review and
meta-analysis. Hum Reprod Update. 2019;
1;25(2):202-223.
4. Chatterjee P, Ghosh S, Mahajan S. Evaluating the
Effectiveness of Platelet Rich Plasma Therapy in
Enhancing Endometrial Receptivity for WoBioallied Sci. 2025;17(Suppl 1):S137-S140.
5. Jin XH, Li Y, Li D. Intrauterine interventions for
women with two or more implantation failures: A
systematic review and network meta-analysis. Front
Endocrinol. 2022;13:959121.
6. Bos-Mikich A, de Oliveira R, Frantz N. Plateletrich
plasma therapy and reproductive medicine. J
Assist Reprod Genet. 2018 May;35(5):753-756.
7. Bos-Mikich A, Ferreira MO, de Oliveira R, Frantz
N. Platelet-rich plasma or blood-derived products to
improve endometrial receptivity? J Assist Reprod
Genet. 2019 Apr;36(4):613-620.
8. Marques LF, Stessuk T, Camargo IC, Sabeh Junior
N, dos Santos L, Ribeiro-Paes JT. Platelet-rich
plasma (PRP): methodological aspects and clinical
applications. Platelets. 2015;26(2):101-13.
9. Kim JH, Park M, Paek JY, Lee WS, Song H, Lyu
SW. Intrauterine Infusion of Human Platelet-Rich
Plasma Improves Endometrial Regeneration and
Pregnancy Outcomes in a Murine Model of
Asherman's Syndrome. Front Physiol. 2020 Feb
14;11:105.men
with Infertility: A Narrative Review. J Pharm
