Failed or canceled frozen embryo transfer (FET) cycles often occur in patients with thin endometrial linings. Existing treatments to increase lining thickness, such as hormone therapy, are not always effective, leaving some patients with little hope of a successful pregnancy.
Now, a new option is on the horizon. Promising results were seen in the first U.S. experience study on intrauterine platelet-rich plasma (PRP) infusion as an adjunct treatment for persistent thin endometrial lining in FET cycles.
“The goal was to find strategies to assist in regenerating the endometrial lining and promote more successful pregnancies,” said UCSF reproductive endocrinologist Heather G. Huddleston, MD, senior author of the study.
Patients in the cohort had a significant improvement in endometrial lining thickness and pregnancy rates after PRP infusion, with no adverse events.
More than 50% of patients gave birth
In this single-arm cohort study, 46 patients with endometrial lining thickness (EMT) of less than 6 millimeters in prior canceled or failed FET cycles were given intrauterine PRP during FET cycles. EMT of less than 7 millimeters at the end of the follicular phase is associated with reduced pregnancy rates and often results in cycle cancelation.
PRP was prepared from each patient’s peripheral blood by separating platelets with centrifugation. It was then slowly infused to the fundus through an intrauterine insemination catheter.
Of 51 cycles, 33 (64.7%) reached an EMT of 7 millimeters or greater after PRP administration. There was a significant difference between pre-PRP EMT and post-PRP EMT in all FET cycles, with a mean difference of 3 ± 1.5 millimeters.
In the cohort of 48 cycles that proceeded to transfer, total pregnancy rate was 72.9%. Three cycles were canceled for failure to reach adequate lining thickness. Clinical pregnancy rate was 54.2% and clinical miscarriage rate was 14.3%. Twenty-six women had live births, 18 with EMT of 7 millimeters or greater and eight with EMT of less than 7 millimeters.
“Thin uterine lining is associated with lower pregnancy rates, higher miscarriage rates and problems with placentation,” Huddleston said. “PRP leverages growth factors that can help with building new blood vessels or repairing areas where fibrosis may be limiting endometrial growth.”
Revolutionizing reproductive medicine
The UCSF Center for Reproductive Health offers a comprehensive array of infertility evaluation methods and treatment options for people of all genders. Patients have access to top fertility experts, the latest technologies, and innovative services based on cutting-edge research.
Huddleston specializes in treating patients with recurrent pregnancy loss; uterine disorders, including Asherman’s syndrome and uterine causes of infertility; and polycystic ovarian syndrome (PCOS). She directs the UCSF PCOS Clinic.
“At UCSF, we are really positioned to take care of the most complicated patient cases,” she said.
To learn more
UCSF Center for Reproductive Health at Mission Bay
UCSF Center for Reproductive Health at Mount Zion
Phone:(415) 353-7475 | Fax: (415) 353-7744
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