Effect of Intrauterine Autologous Platelet-Rich Plasma Instillation in Infertile Women With Thin Endometrium Undergoing Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial

Background: Endometrial thickness is a key factor in determining the suitability for embryo transfer (ET) and influences the success of assisted reproductive technology (ART) outcomes. The aim of this study is to compare endometrial thickness in patients undergoing frozen-thawed e...

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Main Authors: Sootthinan Pothisan, Pitak Laokirkkiat, Somsin Petyim, Isarin Thanaboonyawat, Japarath Prechapanich, Pavarit Humart, Patcharaporn Teammak, Nichamon Parkpinyo
Format: Article
Language:English
Published: IMR Press 2025-07-01
Series:Clinical and Experimental Obstetrics & Gynecology
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Online Access:https://www.imrpress.com/journal/CEOG/52/7/10.31083/CEOG39260
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author Sootthinan Pothisan
Pitak Laokirkkiat
Somsin Petyim
Isarin Thanaboonyawat
Japarath Prechapanich
Pavarit Humart
Patcharaporn Teammak
Nichamon Parkpinyo
author_facet Sootthinan Pothisan
Pitak Laokirkkiat
Somsin Petyim
Isarin Thanaboonyawat
Japarath Prechapanich
Pavarit Humart
Patcharaporn Teammak
Nichamon Parkpinyo
author_sort Sootthinan Pothisan
collection DOAJ
description Background: Endometrial thickness is a key factor in determining the suitability for embryo transfer (ET) and influences the success of assisted reproductive technology (ART) outcomes. The aim of this study is to compare endometrial thickness in patients undergoing frozen-thawed embryo transfer (FET) who received platelet-rich plasma (PRP) injections alongside standard estrogen therapy with those receiving standard estrogen therapy alone. Methods: In this randomized controlled trial (RCT), a total of 30 infertile women from Siriraj Infertility Clinic undergoing FET were enrolled and randomly assigned to three groups. Group 1 (PRP-1 group) received a single intrauterine PRP instillation on day 8 (D8) of the cycle prior to ET; Group 2 (PRP-2 group) received two intrauterine PRP instillations on D8 and D10 before ET; and Group 3 (Control) received standard estrogen therapy alone. Endometrial thickness, chemical pregnancy rate, clinical pregnancy rate, abortion rate, and cycle cancellation rate were recorded. Results: The mean differences in endometrial thickness on D8 and D12 were compared. The PRP-1 group showed the greatest increase in endometrial thickness compared to the other groups; however, the difference was not statistically significance (1.52 ± 1.10 in PRP-1, 0.72 ± 0.72 in PRP-2, 1.43 ± 0.88 in the Control group; p = 0.153). Chemical pregnancy rates were comparable across groups, with 33.34% in PRP-1 group and 42.85% in the control group. Similarly, clinical pregnancy rates were 16.67% in PRP-1 group and 42.85% in the control group; (p = 0.790 and p = 0.585, respectively). However, the cancellation rate was significantly higher in the PRP-2 group (77.78%, p = 0.015). Conclusions: Single intrauterine PRP instillation on D8 prior to ET in a frozen-thawed cycle may improve endometrial thickness, although without statistical significance. In contrast, repeated PRP administration was associated with a higher cycle cancellation rate. Clinical Trial Registration: The study has been registered on https://clinicaltrials.gov/ (registration number: NCT06234540; registration link: https://clinicaltrials.gov/study/NCT06234540?cond=NCT06234540&rank=1).
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spelling doaj-art-2bb7455c083e4822bcd8f82dcac3ccc72025-08-20T04:02:13ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632025-07-015273926010.31083/CEOG39260S0390-6663(25)02631-4Effect of Intrauterine Autologous Platelet-Rich Plasma Instillation in Infertile Women With Thin Endometrium Undergoing Frozen-Thawed Embryo Transfer: A Randomized Controlled TrialSootthinan Pothisan0Pitak Laokirkkiat1Somsin Petyim2Isarin Thanaboonyawat3Japarath Prechapanich4Pavarit Humart5Patcharaporn Teammak6Nichamon Parkpinyo7Department of Reproductive Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, ThailandDepartment of Reproductive Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, ThailandDepartment of Reproductive Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, ThailandDepartment of Reproductive Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, ThailandDepartment of Reproductive Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, ThailandDepartment of Reproductive Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, ThailandDepartment of Reproductive Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, ThailandDepartment of Reproductive Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 10700 Bangkok, ThailandBackground: Endometrial thickness is a key factor in determining the suitability for embryo transfer (ET) and influences the success of assisted reproductive technology (ART) outcomes. The aim of this study is to compare endometrial thickness in patients undergoing frozen-thawed embryo transfer (FET) who received platelet-rich plasma (PRP) injections alongside standard estrogen therapy with those receiving standard estrogen therapy alone. Methods: In this randomized controlled trial (RCT), a total of 30 infertile women from Siriraj Infertility Clinic undergoing FET were enrolled and randomly assigned to three groups. Group 1 (PRP-1 group) received a single intrauterine PRP instillation on day 8 (D8) of the cycle prior to ET; Group 2 (PRP-2 group) received two intrauterine PRP instillations on D8 and D10 before ET; and Group 3 (Control) received standard estrogen therapy alone. Endometrial thickness, chemical pregnancy rate, clinical pregnancy rate, abortion rate, and cycle cancellation rate were recorded. Results: The mean differences in endometrial thickness on D8 and D12 were compared. The PRP-1 group showed the greatest increase in endometrial thickness compared to the other groups; however, the difference was not statistically significance (1.52 ± 1.10 in PRP-1, 0.72 ± 0.72 in PRP-2, 1.43 ± 0.88 in the Control group; p = 0.153). Chemical pregnancy rates were comparable across groups, with 33.34% in PRP-1 group and 42.85% in the control group. Similarly, clinical pregnancy rates were 16.67% in PRP-1 group and 42.85% in the control group; (p = 0.790 and p = 0.585, respectively). However, the cancellation rate was significantly higher in the PRP-2 group (77.78%, p = 0.015). Conclusions: Single intrauterine PRP instillation on D8 prior to ET in a frozen-thawed cycle may improve endometrial thickness, although without statistical significance. In contrast, repeated PRP administration was associated with a higher cycle cancellation rate. Clinical Trial Registration: The study has been registered on https://clinicaltrials.gov/ (registration number: NCT06234540; registration link: https://clinicaltrials.gov/study/NCT06234540?cond=NCT06234540&rank=1).https://www.imrpress.com/journal/CEOG/52/7/10.31083/CEOG39260prpplatelet rich plasmaendometrial thicknessthin endometriumrefractory endometriumivf frozen thaw cycles
spellingShingle Sootthinan Pothisan
Pitak Laokirkkiat
Somsin Petyim
Isarin Thanaboonyawat
Japarath Prechapanich
Pavarit Humart
Patcharaporn Teammak
Nichamon Parkpinyo
Effect of Intrauterine Autologous Platelet-Rich Plasma Instillation in Infertile Women With Thin Endometrium Undergoing Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial
Clinical and Experimental Obstetrics & Gynecology
prp
platelet rich plasma
endometrial thickness
thin endometrium
refractory endometrium
ivf frozen thaw cycles
title Effect of Intrauterine Autologous Platelet-Rich Plasma Instillation in Infertile Women With Thin Endometrium Undergoing Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial
title_full Effect of Intrauterine Autologous Platelet-Rich Plasma Instillation in Infertile Women With Thin Endometrium Undergoing Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial
title_fullStr Effect of Intrauterine Autologous Platelet-Rich Plasma Instillation in Infertile Women With Thin Endometrium Undergoing Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial
title_full_unstemmed Effect of Intrauterine Autologous Platelet-Rich Plasma Instillation in Infertile Women With Thin Endometrium Undergoing Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial
title_short Effect of Intrauterine Autologous Platelet-Rich Plasma Instillation in Infertile Women With Thin Endometrium Undergoing Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial
title_sort effect of intrauterine autologous platelet rich plasma instillation in infertile women with thin endometrium undergoing frozen thawed embryo transfer a randomized controlled trial
topic prp
platelet rich plasma
endometrial thickness
thin endometrium
refractory endometrium
ivf frozen thaw cycles
url https://www.imrpress.com/journal/CEOG/52/7/10.31083/CEOG39260
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