Platelet-Rich Plasma Improves Pregnancy Rate and Repairs Endometrial Injury in Patients with Repeated Implantation Failure

Abstract

Objective: The effects investigated in this study for the therapy with autologous platelet-rich plasma (PRP) on the thin endometrium in a rat model and patients with repeated implantation failure (RIF). Methods: PRP were immediately injected into uterine cavity after the establishing a model of thin endometrial injury by injection with 95% ethanol into uterus of SD rat. We have used H&E staining to explore the endometrial morphological alteration. The immunohistochemistry, Western blots, and quantitative RT-PCR were used to determine the endometrial receptivity. RL95-2 cells were incubated with RPR at the different concentrations to detect the effect of PRP on the endometrial epithelial cell proliferation. Patients (n = 51) were divided into the control and PRP treatment groups. Patients in the PRP treatment group received PRP by intrauterine perfusion. Results: Endometrial morphology was significantly improved after PRP intrauterine infusion thrice-administered SD rats. PRP increased the thickness of thin endometrium in rats and up-regulate the expression of receptivity markers, including vimentin, vascular endothelial growth factor (VEGF) and integrin β3. In the control (n = 25) and PRP treatment (n = 26) groups, no significant differences were observed in rates of clinical pregnancy (50.0% vs. 44.0%, p = 0.67), implantation (40.5% vs. 26.0%, p = 0.15) and miscarriage (30.8% vs. 18.2%, p = 0.48). Conclusions: The transplantation of PRP repairs the endometrial injury by suppressing receptivity, enhancing endometrial cell proliferation and vascular remodeling. PRP improves the pregnancy rate in RIF patients.