Citation Information :
Pandey K, Garg R, Lal P, Upadhyay R, Sahoo G. Effect of Platelet-rich Plasma in Regeneration of Thin Endometrium and Its Implications in in vitro Fertilization Cycles: A Novel Approach. J South Asian Feder Obs Gynae 2020; 12 (5):313-316.
The thin endometrium is an important cause of failure of cycle cancellations in in vitro fertilization (IVF). Several modalities like estrogen, low-dose aspirin, heparin, vaginal sildenafil, pentoxifylline, and granulocyte-colony stimulating factor (G-CSF) intrauterine perfusion have been tried and studied in patients with a thin endometrium. We discuss platelet-rich plasma (PRP) administration by intrauterine infusion as a novel approach in these patients. We reviewed and analyzed all important and relevant articles including case series, pilot studies, and case reports published from January 2000 to December 2020. Studies pertaining to other uses of PRP were not included. We found that intrauterine infusion of PRP can significantly increase the endometrial thickness and improve the pregnancy rates in infertile patients with thin endometrium <6 mm.
Mascarenhas MN, Flaxman SR, Boerma T, et al. National, regional, and global trends in infertility prevalence since 1990: a systematic analysis of 277 health surveys. PLoS Med 2012;9(12). DOI: 10.1371/journal.pmed.1001356.
Gao MZ, Zhao XM, Li WY, et al. Assessment of uterine receptivity by endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound in women undergoing IVF treatment. J Reprod Contracept 2007;18(3):205–212. DOI: 10.1016/S1001-7844(07)60025-X.
El-Toukhy T, Coomarasamy A, Khairy M, et al. The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles. Fertil Steril 2008;89(4):832–839. DOI: 10.1016/j.fertnstert.2007.04.031.
Coughlan C, Ledger W, Wang Q, et al. Recurrent implantation failure: definition and management. Reprod Biomed Online 2014;28(1):14–38. DOI: 10.1016/j.rbmo.2013.08.011.
Simon A, Laufer N. Assessment and treatment of repeated implantation failure (RIF). J Assist Reprod Genet 2012;29(11):1227–1239. DOI: 10.1007/s10815-012-9861-4.
Xu B, Zhang Q, Hao J, et al. Two protocols to treat thin endometrium with granulocyte colony-stimulating factor during frozen embryo transfer cycles. Reprod Biomed Online 2015;30(4):349–358. DOI: 10.1016/j.rbmo.2014.12.006.
Barad DH, Yu Y, Kushnir VA, et al. A randomized clinical trial of endometrial perfusion with granulocyte colony-stimulating factor in in vitro fertilization cycles: Impact on endometrial thickness and clinical pregnancy rates. Fertil Steril 2014;101(3):710–715. DOI: 10.1016/j.fertnstert.2013.12.016.
Lee JW, Kwon OH, Kim TK, et al. Platelet-rich plasma: quantitative assessment of growth factor levels and comparative analysis of activated and inactivated groups. Arch Plast Surg 2013;40(5):530–535. DOI: 10.5999/aps.2013.40.5.530.
Dhillon RS, Schwarz EM, Maloney MD. Platelet-rich plasma therapy - future or trend? Arthritis Res Ther 2012;14(4):219. DOI: 10.1186/ar3914.
Weckstein LN, Jacobson A, Galen D, et al. Low-dose aspirin for oocyte donation recipients with a thin endometrium: prospective, randomized study. Fertil Steril 1997;68(5):927–930. DOI: 10.1016/S0015-0282(97)00330-0.
Ledee-Bataille N, Olivennes F, Lefaix JL, et al. Combined treatment by pentoxifylline and tocopherol for recipient women with a thin endometrium enrolled in an oocyte donation programme. Hum Reprod 2002;17(5):1249–1253. DOI: 10.1093/humrep/17.5.1249.
Dalia I, Nadia A, Makary S, et al. The effect of sildenafil versus estradiol valerate on endometrial thickness and pattern in infertile females. Eur J Pharmaceut Med Res 2018;5:581–584.
Chen MJ, Yang JH, Peng FH, et al. Extended estrogen administration for women with thin endometrium in frozen-thawed in-vitro fertilization programs. J Assist Reprod Genet 2006;23(7-8):337–342. DOI: 10.1007/s10815-006-9053-1.
Ehrenfest DM, Andia I, Zumstein MA, et al. Classification of platelet concentrates (platelet-rich plasma-PRP, platelet-rich fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives. Muscles Ligaments Tendons J 2014;4(1):3. DOI: 10.32098/mltj.01.2014.02.
Weissman A, Gotlieb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in in vitro fertilization program. Fertil Steril 1999;71(1):147–149. DOI: 10.1016/S0015-0282(98)00413-0.
Richter KS, Bugge KR, Bromer JG, et al. Relationship between endometrial thickness and embryo implantation, based on 1294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril 2007;87(1):53–59. DOI: 10.1016/j.fertnstert.2006.05.064.
Chang Y, Li J, Wei L-N, et al. Autologous platelet-rich plasma infusion improves clinical pregnancy rate in frozen embryo transfer cycles for women with thin endometrium. Medicine 2019. 98.
Kim H, Shin JE, Koo HS, et al. Effect of autologous platelet-rich plasma treatment on refractory thin endometrium during the frozen embryo transfer cycle: a pilot study. Frontiers Endocrinol 2019;10:61. DOI: 10.3389/fendo.2019.00061.
Nazari L, Salehpour S, Hoseini S, et al. Effects of autologous platelet-rich plasma on implantation and pregnancy in repeated implantation failure: a pilot study. Int J Reprod Biomed (Yazd) 2016;14(10):625–628. DOI: 10.29252/ijrm.14.10.625.
Colombo GV, Fanton V, Sosa D, et al. Use of platelet rich plasma in human infertility. J Biol Regul Homeost Agents 2017;31(2 Suppl. 2):179–182.
Zadehmodarres S, Salehpour S, Saharkhiz N, et al. Treatment of thin endometrium with autologous platelet-rich plasma: a pilot study. JBRA Assist Reprod 2017;21(1):54. DOI: 10.5935/1518-0557. 20170013.
Molina A, Sánchez J, Sánchez W, et al. Platelet-rich plasma as an adjuvant in the endometrial preparation of patients with refractory endometrium. JBRA Assisted Reproduction 2018;22(1):42–48.
Eftekhar M, Neghab N, Naghshineh E, et al. Can autologous platelet rich plasma expand endometrial thickness and improve pregnancy rate during frozen-thawed embryo transfer cycle? a randomized clinical trial. Taiwanese J Obstet Gynecol 2018;57(6):810–813. DOI: 10.1016/j.tjog.2018.10.007.
Coksuer H, Akdemir Y, Ulas, et al. Improved in vitro fertilization success and pregnancy outcome with autologous platelet-rich plasma treatment in unexplained infertility patients that had repeated implantation failure history. Gynecol Endocrinol 2019;35(9):815–818. DOI: 10.1080/09513590.2019.1597344.
Mehrafza M, Kabodmehri R, Nikpouri Z, et al. Comparing the impact of autologous platelet-rich plasma and granulocyte colony stimulating factor on pregnancy outcome in patients with repeated implantation failure. J Reprod Infertil 2019;20(1):35–41.
Tandulwadkar SR, Naralkar MV, Surana AD, et al. utologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: a pilot study. J Hum Reprod Sci 2017;10(3):208–212. DOI: 10.4103/jhrs.JHRS_28_1727.
Agarwal M, Mettler L, Jain S, et al. Management of a thin endometrium by hysteroscopic instillation of platelet-rich plasma into the endomyometrial junction: a pilot study. J Clin Med 2020;9(9):2795. DOI: 10.3390/jcm9092795.