#96 : The Efficacy of Platelet Rich Plasma Therapy in Thin Endometrium Undergoing Frozen Thawed Embryo Transfer in Assisted Reproductive Technology: A Systematic Review and Meta-Analysis

Background and Aim: Endometrium is one of the main factors in implantation and pregnancy. Adequate thickness of the endometrium is crucial for successful embryo implantation. Thin endometrium significantly increases the risk of embryo implantation failure, as the pregnancy rate in women. Intrauterine infusion of platelet rich plasma (PRP) is a new approach that has been suggested for the treatment of thin endometrium. This meta-analysis was conducted systematically to evaluate the efficacy of PRP therapy on endometrial thickness and pregnancy rates.

Methods: We conducted a systematic review and meta-analysis of the retrieved randomized controlled trial (RCT). Studies on the intra uterine infusion of PRP in women undergoing frozen thawed embryo transfer (FET) in assisted reproductive technology (ART), identified by conducting a systematic search, using PubMed, Cochrane Central Register of Controlled Trials, and Google Scholar. Data were extracted and analyzed independently using random effects model or common effects model according to heterogeneity. Risk of bias assessment was assessed using RoB 2 tools.

Results: Five RCTs involving 377 patients were included in the endometrial thickness outcome. The endometrial thickness between PRP and control group showed a significant probability of increasing endometrial thickness in PRP group (MD 0,83, 95% CI 0,40-1,26, I ² 84%, p<0,01). The rates of chemical pregnancy were significantly higher in PRP group (RR 2,73, 95% CI 1,41-5,27, I ² 51%, p=0,15). The rates of clinical pregnancy were significantly higher in PRP group (RR 1,75, 95% CI 1,29-2,39, I ² 62%, p<0,01). According to RoB evaluation, the overall studie’s quality was minimally bias.

Conclusions: In this systematic review, we concluded that PRP was an effective therapy to increase endometrial thickness and as alternative treatment strategy for thin endometrium undergoing FET in ART. Although this study retrieved some RCT, we suggested that additional RCT were needed to increase the power of study.