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Can PRP infusion improve pregnancy rates but also increase the risk of preterm birth?

moderate confidence  ·  Last reviewed May 18, 2026

Platelet-rich plasma (PRP) infusion is a treatment where a patient's own blood is processed to concentrate platelets and growth factors, then infused into the uterus before embryo transfer. For women with recurrent implantation failure (RIF), PRP appears to improve the chances of pregnancy. However, a recent systematic review and meta-analysis found that while PRP boosts pregnancy and live birth rates, it was also linked to a significantly higher rate of preterm birth. This means the decision to use PRP should carefully weigh potential benefits against possible risks.

What the research says

A 2025 systematic review and meta-analysis of randomized controlled trials examined PRP infusion in women with RIF 4. The analysis showed that PRP significantly improved clinical pregnancy rates (odds ratio 3.18), ongoing pregnancy rates (odds ratio 3.41), and live birth rates (odds ratio 5.10) compared to controls 4. However, the same study found that the preterm birth rate was significantly higher in the PRP group (odds ratio 8.24) 4. This finding was based on a small number of events and had wide confidence intervals, so the true risk may vary, but the signal is concerning.

Other research supports the benefit of PRP for pregnancy outcomes in RIF. A 2023 meta-analysis also reported improved clinical pregnancy and live birth rates with PRP 7. A 2024 network meta-analysis of various uterine infusions, including PRP, found PRP to be among the effective treatments for RIF 6. However, neither of these earlier reviews specifically reported on preterm birth rates 67.

The mechanism by which PRP might increase preterm birth risk is not fully understood. PRP contains growth factors and cytokines that may alter the uterine immune environment. A review on immune regulation in pregnancy notes that dysregulation of immune cells like regulatory T cells (Tregs) is linked to preterm birth 3. PRP could potentially influence these immune pathways, but more research is needed to clarify this connection.

It is important to note that the evidence on PRP for RIF is still evolving. Some studies are ongoing, such as a 2025 protocol investigating PRP for thin endometrium and RIF 8. The current data suggest a trade-off: higher pregnancy success but possibly higher preterm birth risk.

What to ask your doctor

  • Based on my specific history of recurrent implantation failure, what is the expected benefit of PRP infusion for me?
  • What is the estimated risk of preterm birth with PRP in my case, and how would that be monitored?
  • Are there alternative treatments for RIF that might have a lower risk of preterm birth?
  • If I choose PRP, what additional monitoring during pregnancy would you recommend to watch for preterm labor?
  • Can you explain how the PRP procedure is done and what the evidence says about its safety in the long term?

This question is drawn from common patient questions about OB/GYN & Women's Health and answered using cited medical research. We do not provide individualized advice.