Evaluation of adding autologous platelet-rich plasma to embryo transfer media on implantation outcomes: An RCT.

Background: Several recent studies have shown the beneficial effect of platelet-rich plasma (PRP) in improving endometrial function in cases with repeated implantation failure and thin endometrium. However, the mechanism of this effect is unclear.

Objective: To investigate the direct effect of PRP on the implantation process during embryo transfer (ET) in cases without an obvious history of abnormality on implantation.

Materials and methods: In this randomized clinical trial study, 55 infertile women (20-40 yr) who were candidates for intracytoplasmic sperm injection referred to the Infertility Center of Fatemiyeh hospital in Hamadan, Iran between September 2022 and 2023were randomly divided into intervention and control groups. In the intervention group, PRP was added to the ET medium, while in the control group, a routine ET medium was used. After ET, chemical and clinical pregnancy were measured.

Results: In the intervention and control groups beta human chorionic gonadotropin positivity 14 days after transfer was 33.3% and 39.3%, consecutively (p = 0.646). On day 21 post-transfer, a gestational sac was observed in 33.3% and 35.7% of cases (p = 0.646). By 28 days after transfer fetal heart activity was detected in 33.3% and 35.7% of cases (p = 0.631).

Conclusion: The addition of autologous PRP at the time of ET does not have a direct positive effect on embryo implantation, and the observation of positive effects in previous studies may be indirectly on the uterine microenvironment, which requires time.