Key points about PRP and fertility:

• PRP (Platelet Rich Plasma) is a concentrate derived from the patient's own blood that promotes cell regeneration.

• PRP is injected into the ovaries to improve the ovarian reserve.

• Alternatively, PRP is introduced into the uterus to support the endometrium and implantation.

• Initial studies show positive effects on diminished ovarian reserve and implantation failure.

• The treatment is considered well-tolerated since PRP is derived from the body’s own cells.

• Further studies are needed to confirm its long-term effectiveness.

Modern reproductive medicine continues to evolve to provide new options for couples experiencing infertility. One promising method that has been increasingly researched in recent years is the use of Platelet Rich Plasma (PRP). PRP is a concentrate derived from the patient's own blood, rich in growth factors and regenerative components. It has already been utilized in various medical fields, including orthopedics, dermatology, and aesthetic medicine. But can PRP also improve fertility?

What is PRP and how does it work?

PRP is obtained through a specialized preparation of the patient’s own blood, concentrating platelets (thrombocytes) that contain various growth factors. These factors promote cell regeneration, blood circulation, and tissue repair. In reproductive medicine, PRP is primarily used in two areas:

Intraovarian PRP Therapy

PRP is injected directly into the ovaries to improve ovarian function. The procedure is usually performed under sedation or light anesthesia, similar to an egg retrieval. Studies suggest that PRP may positively influence ovarian reserve in women with diminished ovarian function (Barrenetxea G., et al., 2024).

Intrauterine PRP Infusion

This method is used in women experiencing repeated implantation failure or a thin endometrium. PRP may increase endometrial thickness and the likelihood of both chemical and clinical pregnancies (Sharara, F.I., et al., 2021).

PRP for diminished ovarian reserve

Women with diminished ovarian reserve or premature ovarian insufficiency (POI) often have a low number of viable eggs, reducing their chances of a successful pregnancy. PRP may provide a new way to stimulate ovarian function. With intrauterine PRP infusion, PRP is injected into the uterus, and some women report mild cramping during the procedure. A systematic review found that PRP injections could increase the number of retrieved eggs and embryos (Éliás, M., et al., 2024).

PRP for improving endometrial receptivity

A thin endometrium can make embryo implantation difficult, leading to repeated implantation failure. PRP may help increase endometrial thickness and enhance blood circulation. A meta-analysis showed that PRP infusions can improve pregnancy rates in women with recurrent implantation failure (Xie, Q., et al., 2024). This suggests that PRP may be a promising addition to existing fertility treatments.

Scientific evidence and open questions

Although PRP has shown promising results, there are still open questions about the optimal application and dosage. Some experts caution against viewing PRP as a "miracle cure" since scientific evidence is still limited. Further randomized controlled trials are necessary to confirm its long-term safety and effectiveness (Adiga, P.K., et al., 2024).

Conclusion: PRP as a hopeful treatment in reproductive medicine?

PRP may offer an innovative option for addressing fertility issues, particularly in women with diminished ovarian reserve or implantation failure. However, it is important to note that there are currently not enough studies to universally recommend PRP. Some studies show promising results, while others find little significant improvement. Even researchers who report positive outcomes emphasize that further studies are needed to validate these findings. Therefore, a thorough consultation with a reproductive specialist is recommended for anyone considering PRP treatment.

Frequently Asked Questions

What exactly is PRP?

PRP stands for Platelet Rich Plasma, a concentrate derived from the patient’s own blood that is rich in growth factors. It is used to promote cell regeneration and tissue repair.

How is PRP used in reproductive medicine?

PRP can be injected directly into the ovaries (intraovarian PRP therapy) or introduced into the uterus (intrauterine PRP infusion) to improve ovarian reserve or endometrial receptivity.

Is there scientific evidence supporting PRP’s effectiveness?

Several studies have shown that PRP can positively impact ovarian reserve and endometrial thickness. However, further randomized controlled trials are required to confirm its long-term effectiveness.

Is PRP a safe treatment?

Since PRP is derived from the patient’s own blood, the risk of side effects is minimal. However, treatment should always be performed under medical supervision.

Who is PRP particularly suitable for?

PRP may be a promising option for women with diminished ovarian reserve, implantation failure, or a thin endometrium.

How long does it take for PRP to take effect?

PRP's effectiveness varies from person to person. Some studies report improvements within weeks, while others suggest a longer observation period.

Is PRP treatment painful?

According to patient reports, PRP treatment is generally not painful. Intraovarian PRP injections are typically performed under sedation or mild anesthesia, similar to an egg retrieval procedure. When PRP is introduced into the uterus, most women experience only mild cramping or a short-lived pressure sensation, comparable to an artificial insemination procedure.

References

1. Éliás, M., Kónya, M., Kekk, Z. et al. Platelet-rich plasma (PRP) treatment of the ovaries significantly improves fertility parameters and reproductive outcomes in diminished ovarian reserve patients: a systematic review and meta-analysis. J Ovarian Res 17, 104 (2024). 

2. Sharara, F. I., Lelea, L. L., Rahman, S., Klebanoff, J. S., & Moawad, G. N. (2021). A narrative review of platelet-rich plasma (PRP) in reproductive medicine. Journal of assisted reproduction and genetics, 38(5), 1003–1012.

3. Barrenetxea, G., Celis, R., Barrenetxea, J., Martínez, E., De Las Heras, M., Gómez, O., Aguirre, O. Intraovarian platelet-rich plasma injection and IVF outcomes in patients with poor ovarian response: a double-blind randomized controlled trial. Human Reproduction, Volume 39, Issue 4, April 2024, Pages 760–769. 

4. Xie, Q., Quan, X., Lan, Y., & Yang, X. (2024). Uterine infusion strategies for infertile patients with recurrent implantation failure: a systematic review and network meta-analysis. Reproductive Biology and Endocrinology, 22(1), 44. 

5. Adiga, P.K., Marconi, N., R. et al. Effect of intra-ovarian injection of platelet-rich plasma on the patients with a poor ovarian response (POR) or premature ovarian insufficiency (POI): a systematic review and meta-analysis. Middle East Fertil Soc J 29, 24 (2024).