Brief Report

The Effect of Intrauterine Injection of Platelet-Rich Plasma on Pregnancy Outcomes in In-Vitro-Fertilization Candidates with Recurrent Implantation Failure

Abstract

Background: Platelet-rich plasma (PRP) contains over 20 growth factors and protein molecules that play a role in cell proliferation, differentiation, and regeneration. This study was designed to evaluate the impact of intrauterine PRP injection on women who have experienced recurrent implantation failure (RIF).

Methods: The present clinical trial involved 94 patients with RIF who were scheduled for in vitro fertilization (IVF). For the intervention (PRP) group, PRP was injected into the uterus using an intrauterine insemination catheter 24 to 48 hours before embryo transfer. The study then assessed and compared pregnancy rates between the intervention and control groups.

Results: This study found no significant baseline differences between the two groups. Endometrial thickness (ET) was comparable, measuring 7.50 ± 0.41 mm in the PRP group and 7.53 ± 0.56 mm in the control group. The PRP group exhibited significantly higher rates of both biochemical and clinical pregnancy. Specifically, the biochemical pregnancy rate was 64.6% (n = 39) in the PRP group compared to 19.6% (n = 9) in the control group (p < 0.001). Similarly, the clinical pregnancy rate was significantly higher in the PRP group at 50% (n = 24) versus 17.4% (n = 8) in the control group (p = 0.001).

Conclusion: The findings of this study reveal that the intrauterine injection of PRP prior to embryo transfer is a safe and affordable intervention that improves the pregnancy rate, with no major adverse effects observed.

1. Amirkhanloo F, Javanbakht M, Lotfi S, Sahraiyan G, Akbari R, Feizabad E, et al. The Effect of Intrauterine Administration of Growth Hormone on IVF Success Rate in Recurrent Implantation Failure Women: A Randomized Clinical Trial. Iran J Pharm Res. 2024;23(1):e153636.
2. Li ZJ, Choi HI, Choi DK, Sohn KC, Im M, Young-Joon S, et al. Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg. 2012; 38:1040-6.
3. Chang Y, Li J, Chen Y, Wei L, Yang X, Shi Y, et al. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization. Int J Clin Exp Med. 2015; 8:1286.
4. Frantz N, Ferreira M, Kulmann MI, Frantz G, Bos-Mikich A, Oliveira R. Platelet-rich plasma as an effective alternative approach for improving endometrial receptivity-a clinical retrospective study. JBRA Assist Reprod. 2020; 24: 442.
5. Wang X, Liu L, Mou S, Zhao H, Fang J, Xiang Y, 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; 120:7403-11.
6. Safdarian L, Aleyasin A, Aghahoseini M, Lak P, Mosa SH, Sarvi F, et al. Efficacy of the Intrauterine Infusion of Platelet-Rich Plasma on Pregnancy Outcomes in Patients With Repeated Implantation Failure: A Randomized Control Trial. Int J Women's Health Reprod Sci. 2022;10(1): 38-44.
7. Nazari L, Salehpour S, Hoseini S, Zadehmodarres S, Ajori L. Effects of autologous platelet-rich plasma on implantation and pregnancy in repeated implantation failure: A pilot study. Int J Reprod Biomed. 2016; 14: 625-628.
8. Davari Tanha F, Salimi Setudeh S, Ebrahimi M, Feizabad E, Khalaj Sereshki Z, Akbari Asbagh F, et al. Effect of intra-ovarian platelet rich plasma in women with poor ovarian response. Caspian J Intern Med. 2023;14:485-489.
9. Busnelli A, Somigliana E, Cirillo F, Baggiani A, Levi-Setti PE. Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis. Sci Rep. 2021; 11: 1747.
10. Sommeling CE, Heyneman A, Hoeksema H, Verbelen J, Stillaert FB, Monstrey S. The use of platelet-rich plasma in plastic surgery: a systematic review. J Plast Reconstr Aesthet Surg. 2013; 66: 301-11.
10. Raja SV, Naidu ME. Platelet-rich fibrin: evolution of a second-generation platelet concentrates. Indian J Dent Res. 2008; 19: 42- 46.
11. Senzel L, Gnatenko DV, Bahou WF. The platelet proteome. Curr Opin Hematol. 2009; 5: 32-33.
12. Lin PY, Lee CI, Chen YC, Cheng EH, Huang CC, Chen CI, et al. Factors Affecting the Potential Efficacy of Intrauterine Platelet-Rich Plasma Infusion on Thin Endometrium in Women with Recurrent Implantation Failure. J Pers Med. 2023; 13: 1419.
13. Busnelli A, Somigliana E, Cirillo F, Baggiani A, Levi-Setti PE. Efficacy of therapies and interventions for repeated embryo implantation failure: a systematic review and meta-analysis. Sci Rep. 2021; 11: 1747.
14. Kim H, Shin JE, Koo HS, Kwon H, Choi DH, Kim JH. Effect of Autologous Platelet-Rich Plasma Treatment on Refractory Thin Endometrium during the Frozen Embryo Transfer Cycle: A Pilot Study. Front Endocrinol (Lausanne). 2019; 10: 61.
15. Tehraninejad ES, Kashani NG, Hosseini A, Tarafdari A. Autologous platelet‐rich plasma infusion does not improve pregnancy outcomes in frozen embryo transfer cycles in women with history of repeated implantation failure without thin endometrium. J Obstet Gynaecol Res. 2021;47:147-51.
16. Allahveisi A, Fariba Seyedoshohadaei F, Rezaei M, Bazrafshan N, Rahimi K. The effect of platelet-rich plasma on the achievement of pregnancy during frozen embryo transfer in women with a history of failed implantation. Heliyon. 2020; 6(3): e03577.
17. Karadbhajne P, Dzoagbe HY, More A. Platelet-Rich Plasma (PRP) for Endometrial Treatment Efficacy and Safety in Assisted Reproductive Technology: A Comprehensive Review. Cureus. 2024; 16: e59728.
18. Aghajanzadeh F, Esmaeilzadeh S, Basirat Z, Mahouti T, Heidari FN, Golsorkhtabaramiri M. Using autologous intrauterine platelet-rich plasma to improve the reproductive outcomes of women with recurrent implantation failure. JBRA Assist Reprod. 2020; 24:30-33.
19. Eftekhar M, Neghab N, Khani P. Effectiveness of Autologous Platelet-Rich Plasma Therapy in Women with Repeated Implantation Failure: A Randomized Clinical Trial. Int J Fertil Steril. 2024; 18: 162–166.
Files
IssueVol 13, No 3 (Summer 2025) QRcode
SectionBrief Report
DOI https://doi.org/10.18502/jpc.v13i3.20325
Keywords
Platelet-Rich Plasma Infertility Implantation In-Vitro-Fertilization

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Akbari Asbagh F, Ebrahimi M, Asan E, Faraji N, Pourmand N, Mohammadkhani R, Falahatgar S. The Effect of Intrauterine Injection of Platelet-Rich Plasma on Pregnancy Outcomes in In-Vitro-Fertilization Candidates with Recurrent Implantation Failure. J Pharm Care. 2025;13(3):224-229.