Autologous Platelet-Rich Plasma Combined with Endometrial Microstimulation to Improve Thin Endometrium Status and Clinical Outcomes: A Prospective Controlled Study.

Abstract

Objective: This study aimed to evaluate the effect of a novel intrauterine infusion of autologous platelet-rich plasma (PRP) on endometrial condition and clinical outcomes in patients with thin endometrium undergoing frozen-thawed embryo transfer (FET) cycles.

Methods: A prospective randomized controlled trial was conducted with 70 patients diagnosed with thin endometrium at the Reproductive Medicine Center of Shenzhen Maternal and Child Health Hospital from January 2022 to June 2023. The patients were randomly divided into two groups: a single PRP infusion group and a PRP combined with endometrial microstimulation (EM+PRP) group. Endometrial thickness and classification were assessed before and after treatment. Clinical outcomes, including human chorionic gonadotropin (HCG) positivity rate, embryo implantation rate, clinical pregnancy rate, and early miscarriage rate, were analyzed.

Results: Baseline characteristics, including pre-treatment endometrial thickness, were comparable between groups. Both groups showed a significant increase in endometrial thickness after treatment (P<0.05). The EM+PRP group exhibited a greater improvement in post-treatment endometrial thickness compared to the single PRP group (P<0.05). Endometrial morphology showed improvement in both groups, but the difference was not statistically significant (P>0.05). No significant differences were found between the two groups in terms of HCG positivity rate, embryo implantation rate, clinical pregnancy rate, or early miscarriage rate.

Conclusion: Both EM+PRP and single PRP intrauterine infusion effectively increased endometrial thickness and improved clinical outcomes in patients with thin endometrium. The combined EM+PRP therapy showed potential for greater efficacy in improving endometrial condition, warranting further research in larger, multicenter studies.