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PRP infusion improves pregnancy rates in recurrent implantation failure but may increase preterm birthsPlatelet Plasma Boosts Pregnancy in Repeat Failures

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Key Takeaway
Consider PRP for RIF in select cases but watch for preterm birth risk.

This systematic review and meta-analysis evaluated intrauterine autologous platelet-rich plasma (PRP) infusion in women with recurrent implantation failure (RIF), compared to controls. The primary outcome was clinical pregnancy rate (CPR), with secondary outcomes including biochemical pregnancy rate (BPR), ongoing pregnancy rate (OPR), live birth rate (LBR), miscarriage rate (MR), and preterm birth rate. Sample size, setting, and follow-up were not reported.

Main results showed significant improvements with PRP: CPR had an odds ratio (OR) of 3.18 (95% CI 2.45 to 4.14, I2 = 3%), BPR OR 2.84 (95% CI 2.22 to 3.63, I2 = 0%), OPR OR 3.41 (95% CI 2.08 to 5.60, I2 = 30%), and LBR OR 5.10 (95% CI 1.95 to 13.37, I2 = 75%). In subgroup analyses, benefits were particularly notable for blastocyst transfers (e.g., CPR OR 3.84, 95% CI 2.82 to 5.23) and women with ≥3 prior implantation failures (e.g., LBR OR 7.32, 95% CI 3.17 to 16.90), with reduced MR in these subgroups (OR 0.27, 95% CI 0.07 to 0.96). However, overall MR was not reduced, and preterm birth rate was significantly higher in the PRP group (OR 8.24, 95% CI 2.09 to 32.41, I2 = 0%).

Safety data indicated a higher preterm birth rate with PRP, but serious adverse events, discontinuations, and tolerability were not reported. Limitations include the need for further investigation into the preterm birth risk, and the role of PRP in RIF remains controversial, with no benefit shown for those with a history of ≥2 failed cycles. Practice relevance suggests a possible beneficial role for PRP in improving pregnancy outcomes, especially in specific subgroups, but clinicians should weigh this against the potential increase in preterm births.

Many couples face a heartbreaking cycle of failed pregnancies. They try again and again, only to watch the dream fade. Now, new research offers a fresh hope for those who have hit a wall.

Recurrent implantation failure happens when an embryo stops growing inside the uterus. It is a frustrating condition that leaves many women and families feeling stuck. Current treatments often focus on hormones or fixing the womb lining. But these methods do not always work.

Doctors need new tools to help these patients. This study looks at a substance called platelet-rich plasma, or PRP. Think of PRP as a concentrated boost of healing cells from your own blood. It is already used to heal wounds and joints. Now, doctors are testing it to help embryos stick to the womb wall.

The surprising shift

For years, scientists were unsure if PRP helped with repeat failures. Some clinics used it, while others waited for proof. This new review changes that conversation. It shows clear signs that PRP can improve success rates.

But here is the twist. The results depend on how the embryo is transferred. The study found that using PRP with advanced embryos worked best. Using it with earlier-stage embryos did not show the same benefits.

What scientists didn't expect

The biology behind this is simple yet powerful. Your blood contains platelets. These tiny cells release growth factors. These factors tell the lining of the womb to heal and prepare for a baby.

Imagine the womb lining is a garden bed. Sometimes, the soil is too poor for seeds to grow. PRP acts like a special fertilizer. It adds nutrients and signals that tell the soil to get ready. This helps the embryo anchor itself securely.

The numbers tell a strong story. Women who received PRP were much more likely to have a clinical pregnancy. The odds of success were more than three times higher than in the control group.

Live birth rates also jumped significantly. In fact, the chance of having a baby was over five times higher for some groups. This is huge news for families who have waited years for a positive result.

This doesn't mean this treatment is available yet.

There is a catch. The study also found a potential risk. Women in the PRP group had a higher rate of preterm birth. This means the baby might be born a bit early. Scientists are still studying why this happens. It could be related to how the womb reacts to the treatment.

If you have had many failed transfers, talk to your doctor about PRP. It looks promising, especially if you have had three or more failures. It also works best when using blastocyst-stage embryos.

However, do not expect a magic fix. This is still a developing treatment. You must discuss the risks with your fertility specialist. They can weigh the benefits against the chance of early delivery.

More research is needed to understand the preterm birth risk. Scientists want to know exactly why this happens. They also need to see if this works for everyone.

It may take years before this becomes a standard option. For now, it remains a powerful tool in the right hands. The goal is to help more families build their families safely.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
ObjectiveThe role of intrauterine PRP infusion in managing recurrent implantation failure (RIF) remains controversial despite its emerging clinical use. This systematic review aims to evaluate its therapeutic potential in RIF patients and further to investigate variations in outcomes based on transfer cycle type, embryo developmental stage, RIF diagnostic criteria, and endometrial thickness.MethodsWe systematically searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Scopus, and Web of Science for randomized controlled trials (RCTs) investigating PRP treatment for RIF patients from the beginning of the database to May 2025.ResultsThis meta-analysis showed that PRP administration significantly improved clinical pregnancy rate (CPR) [OR = 3.18, 95%CI (2.45, 4.14), I2 = 3%], biochemical pregnancy rate (BPR) [OR = 2.84, 95%CI (2.22, 3.63), I2 = 0%], ongoing pregnancy rate (OPR) [OR = 3.41, 95%CI (2.08, 5.60), I2 = 30%] and live birth rate (LBR) [OR=5.10, 95%CI (1.95, 13.37), I2 = 75%] in women with RIF. However, PRP intrauterine infusion did not reduce miscarriage rate (MR). Notably, the preterm birth rate was significantly higher in the PRP group compared to controls [OR = 8.24, 95%CI (2.09, 32.41), I2 = 0%]. Subgroup analysis demonstrated that PRP improved CPR, BPR and LBR in both the fresh and frozen embryo transfer cycles. Additionally, while PRP increased CPR, LBR and reduced MR in blastocyst transfers [CPR OR = 3.84, 95%CI (2.82, 5.23), I2 = 0%; LBR OR = 7.32, 95%CI (3.17, 16.90), I2 = 63%; MR OR = 0.27, 95%CI (0.07, 0.96), I2 = 54%], these effects were not observed in cleavage-stage embryo transfers. Moreover, PRP administration associated with a higher CPR [OR = 3.84, 95%CI (2.82, 5.23), I2 = 0%], OPR[OR = 4.13, 95%CI (1.79, 9.56), I2 = 48%], LBR [OR = 7.32, 95%CI (3.17, 16.90), I2 = 63%] and a lower MR [OR = 0.27, 95%CI (0.07, 0.96), I2 = 54%] in women with ≥3 prior implantation failure, it did not confer the same benefit to those with a history of ≥2 failed cycles.ConclusionThese findings suggest a possible beneficial role for PRP on pregnancy outcomes to some extent in women with RIF, particularly in cases with ≥3 prior failed transfers, and blastocyst transfer may increase LBR and reduce miscarriage risk. However, further investigation is warranted to determine whether this treatment may pose an increased risk of preterm birth.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD420251061511.
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