Effects of autologous platelet-rich plasma intrauterine perfusion on clinical outcomes in recurrent implantation failure patients with non-thin endometrium undergoing frozen-thawed embryo transfer

Abstract Purpose To explore the effects of autologous platelet-rich plasma (PRP) intrauterine perfusion on clinical outcomes in recurrent implantation failure (RIF) patients with non-thin endometrium undergoing frozen-thawed embryo transfer (FET), and the effects of PRP used at different times before FET on clinical outcomes. Methods A total of 160 RIF patients with non-thin endometrium undergoing FET were retrospectively analyzed. Among them, 82 patients received PRP intrauterine perfusion at 24–72 hours before FET(PRP group), and 78 patients did not (non-PRP group). In PRP group, 59 patients underwent PRP at 24 ~ 48h before FET(≥ 24 ~ ≤ 48h group), and 23 patients was at 48 ~ 72h (> 48 ~ ≤ 72h group). The clinical outcomes were compared, including β-hCG positive rate, clinical pregnancy rate, embryo implantation rate, abortion rate, ectopic pregnancy rate, live birth rate and the incidence of adverse events. Results The clinical pregnancy rate, embryo implantation rate and live birth rate in PRP group were significantly higher than those in non-PRP group (P < 0.05), and there were no statistical differences in β-hCG rate, abortion rate and ectopic pregnancy rate between the two groups (P > 0.05). Meanwhile, there was no adverse events occurred in PRP group. However, the C-type endometrium rate in PRP group was observably higher on FET day (X2 = 8.309, P = 0.004), though there was no statistical difference in endometrial thickness (P > 0.05). The multiple logistics regression analysis showed that PRP intrauterine perfusion are closely related with clinical pregnancy and live birth in RIF patients with non-thin endometrium (OR:2.379, 95%CI:1.137 ~ 4.977, P = 0.021; OR:2.107, 95% CI:1.006 ~ 4.412, P = 0.048). Moreover, we found no significant difference in clinical outcomes between the two groups of PRP intrauterine perfusion at ≥ 24 ~ ≤ 48h and > 48 ~ ≤ 72h before FET (P > 0.05), except for β-hCG positive rate. Conclusions PRP intrauterine perfusion can safely and effectively improve the clinical pregnancy rate, implantation rate and live birth rate in RIF patients with non-thin endometrium possibly by increasing the C-type endometrium rate on FET day. In addition, PRP intrauterine perfusion at different times of 24 ~ 72 hours before FET does not affect the clinical outcomes, which will be helpful to guide clinical work flexibly.