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Erschienen in: Journal of Assisted Reproduction and Genetics 5/2021

15.03.2021 | Review

A narrative review of platelet-rich plasma (PRP) in reproductive medicine

verfasst von: Fady I. Sharara, Latashia-Lika Lelea, Sara Rahman, Jordan S. Klebanoff, Gaby N. Moawad

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 5/2021

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Abstract

Purpose

Platelet-rich plasma (PRP) has become a novel treatment in various aspects of medicine including orthopedics, cardiothoracic surgery, plastic surgery, dermatology, dentistry, and diabetic wound healing. PRP is now starting to become an area of interest in reproductive medicine more specifically focusing on infertility. Poor ovarian reserve, menopause, premature ovarian failure, and thin endometrium have been the main areas of research. The aim of this article is to review the existing literature on the effects of autologous PRP in reproductive medicine providing a summation of the current studies and assessing the need for additional research.

Methods

A literature search is performed using PubMed, MEDLINE, and CINAHL Plus to identify studies focusing on the use of PRP therapy in reproductive medicine. Articles were divided into 3 categories: PRP in thin lining, PRP in poor ovarian reserve, and PRP in recurrent implantation failure.

Results

In women with thin endometrium, the literature shows an increase in endometrial thickness and increase in chemical and clinical pregnancy rates following autologous PRP therapy. In women with poor ovarian reserve, autologous intraovarian PRP therapy increased anti-Mullerian hormone (AMH) levels and decreased follicle-stimulating hormone (FSH), with a trend toward increasing clinical and live birth rates. This trend was also noted in women with recurrent implantation failure.

Conclusions

Limited literature shows promise in increasing endometrial thickness, increasing AMH, and decreasing FSH levels, as well as increasing chemical and clinical pregnancy rates. The lack of standardization of PRP preparation along with the lack of large randomized controlled trials needs to be addressed in future studies. Until definitive large RCTs are available, PRP use should be considered experimental.
Literatur
1.
Zurück zum Zitat Aghajanova L, Houshdaran S, Balayan S, Manvelyan E, Irwin J, Huddleston H, et al. In vitro evidence that platelet-rich plasma stimulates cellular processes involved in endometrial regeneration. J Assist Reprod Genet. 2018;35:757–70.PubMedPubMedCentralCrossRef Aghajanova L, Houshdaran S, Balayan S, Manvelyan E, Irwin J, Huddleston H, et al. In vitro evidence that platelet-rich plasma stimulates cellular processes involved in endometrial regeneration. J Assist Reprod Genet. 2018;35:757–70.PubMedPubMedCentralCrossRef
2.
Zurück zum Zitat Kim H, Shin J, Koo H, Kwon H, Choi D, Kim J. Effect of autologous platelet-rich plasma treatment on refractory thin endometrium during the frozen embryo transfer cycle: a pilot study. Front Endocrinol. 2019;10:1–9.CrossRef Kim H, Shin J, Koo H, Kwon H, Choi D, Kim J. Effect of autologous platelet-rich plasma treatment on refractory thin endometrium during the frozen embryo transfer cycle: a pilot study. Front Endocrinol. 2019;10:1–9.CrossRef
3.
Zurück zum Zitat Mouhayar Y, Sharara FI. G-CSF and stem cell therapy for the treatment of refractory thin lining in assisted reproductive technology. J Assist Reprod Genet. 2017;34:831–7.PubMedPubMedCentralCrossRef Mouhayar Y, Sharara FI. G-CSF and stem cell therapy for the treatment of refractory thin lining in assisted reproductive technology. J Assist Reprod Genet. 2017;34:831–7.PubMedPubMedCentralCrossRef
4.
Zurück zum Zitat Du J, Lu H, Yu X, Lu Z, Mi L, Zhang X. Efficacy and safety of platelet-rich plasma for the treatment of thin endometrium: a protocol for systematic review and meta-analysis. Medicine. 2020;99:1–4. Du J, Lu H, Yu X, Lu Z, Mi L, Zhang X. Efficacy and safety of platelet-rich plasma for the treatment of thin endometrium: a protocol for systematic review and meta-analysis. Medicine. 2020;99:1–4.
5.
Zurück zum Zitat Coksuer H, Akdemir Y, Barut M. Improved in vitro fertilization success and pregnancy outcome with autologous platelet-rich plasma treatment in unexplained infertility patients that had repeated implantation failure history. Gynecol Endocrinol. 2019:1–6. Coksuer H, Akdemir Y, Barut M. Improved in vitro fertilization success and pregnancy outcome with autologous platelet-rich plasma treatment in unexplained infertility patients that had repeated implantation failure history. Gynecol Endocrinol. 2019:1–6.
6.
Zurück zum Zitat Eftekhar M, Neghab N, Naghshineh E, Khani P. Can autologous platelet rich plasma expand endometrial thickness and improve pregnancy rate during frozen-thawed embryo transfer cycle? A randomized clinical trial. Taiwan J Obstet Gynecol. 2018;57:810–3.PubMedCrossRef Eftekhar M, Neghab N, Naghshineh E, Khani P. Can autologous platelet rich plasma expand endometrial thickness and improve pregnancy rate during frozen-thawed embryo transfer cycle? A randomized clinical trial. Taiwan J Obstet Gynecol. 2018;57:810–3.PubMedCrossRef
7.
Zurück zum Zitat Chang Y, Li J, Chen Y, Wei L, Yang X, Shi Y, et al. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization. Int J Clin Exp Med. 2015;8:1286–90.PubMedPubMedCentral Chang Y, Li J, Chen Y, Wei L, Yang X, Shi Y, et al. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization. Int J Clin Exp Med. 2015;8:1286–90.PubMedPubMedCentral
8.
Zurück zum Zitat Farimani M, Poorolajal J, Rabiee S, Bahmanzadeh M. Successful pregnancy and live birth after intrauterine administration of autologous platelet-rich plasma in a woman with recurrent implantation failure: a case report. Int J Reprod BioMed. 2017;15:803–6.PubMedPubMedCentral Farimani M, Poorolajal J, Rabiee S, Bahmanzadeh M. Successful pregnancy and live birth after intrauterine administration of autologous platelet-rich plasma in a woman with recurrent implantation failure: a case report. Int J Reprod BioMed. 2017;15:803–6.PubMedPubMedCentral
9.
Zurück zum Zitat Nazari L, Salehpour S, Hoseini S, Zadehmodarres S, Azargashb E. Effects of autologous platelet-rich plasma on endometrial expansion in patients undergoing frozen-thawed embryo transfer: a double-blind RCT. Int J Reprod BioMed. 2019;17:443–8.PubMedPubMedCentral Nazari L, Salehpour S, Hoseini S, Zadehmodarres S, Azargashb E. Effects of autologous platelet-rich plasma on endometrial expansion in patients undergoing frozen-thawed embryo transfer: a double-blind RCT. Int J Reprod BioMed. 2019;17:443–8.PubMedPubMedCentral
11.
Zurück zum Zitat Pantos K, Simopoulou M, Pantou A, Rapani A, Tsioulou P, Nitsos N, et al. A case series on natural conceptions resulting in ongoing pregnancies in menopausal and prematurely menopausal women following platelet-rich plasma treatment. Cell Transplant. 2019;28:1333–40.PubMedPubMedCentralCrossRef Pantos K, Simopoulou M, Pantou A, Rapani A, Tsioulou P, Nitsos N, et al. A case series on natural conceptions resulting in ongoing pregnancies in menopausal and prematurely menopausal women following platelet-rich plasma treatment. Cell Transplant. 2019;28:1333–40.PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat Dragoo JL, Wasterlain AS, Braun HJ, Nead KT. Platelet-rich plasma as a treatment for patellar tendinopathy: a double-blind, randomized controlled trial. Am J Sports Med. 2014;42(3):610–8.PubMedCrossRef Dragoo JL, Wasterlain AS, Braun HJ, Nead KT. Platelet-rich plasma as a treatment for patellar tendinopathy: a double-blind, randomized controlled trial. Am J Sports Med. 2014;42(3):610–8.PubMedCrossRef
13.
Zurück zum Zitat Jo CH, Shin JS, Lee YG, Shin WH, Kim H, Lee SY, et al. Platelet-rich plasma for arthroscopic repair of large to massive rotator cuff tears: a randomized, single-blind, parallel-group trial. Am J Sports Med. 2013;41(10):2240–8.PubMedCrossRef Jo CH, Shin JS, Lee YG, Shin WH, Kim H, Lee SY, et al. Platelet-rich plasma for arthroscopic repair of large to massive rotator cuff tears: a randomized, single-blind, parallel-group trial. Am J Sports Med. 2013;41(10):2240–8.PubMedCrossRef
14.
Zurück zum Zitat Cervelli V, Gentile P, Scioli MG, Grimaldi M, Casciani CU, Spagnoli LG, et al. Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation. Tissue Eng Part C Methods. 2009;15(4):625–34.PubMedCrossRef Cervelli V, Gentile P, Scioli MG, Grimaldi M, Casciani CU, Spagnoli LG, et al. Application of platelet-rich plasma in plastic surgery: clinical and in vitro evaluation. Tissue Eng Part C Methods. 2009;15(4):625–34.PubMedCrossRef
15.
Zurück zum Zitat Picard F, Hersant B, Bosc R, Meningaud JP. The growing evidence for the use of platelet-rich plasma on diabetic chronic wounds: a review and a proposal for a new standard care. Wound Repair Regen. 2015;23(5):638–43.PubMedCrossRef Picard F, Hersant B, Bosc R, Meningaud JP. The growing evidence for the use of platelet-rich plasma on diabetic chronic wounds: a review and a proposal for a new standard care. Wound Repair Regen. 2015;23(5):638–43.PubMedCrossRef
16.
Zurück zum Zitat Dawood A, Salem H. Current clinical applications of platelet-rich plasma in various gynecological disorders: an appraisal of theory and practice. Clin Exp Reprod Med. 2018;45:67–74.PubMedPubMedCentralCrossRef Dawood A, Salem H. Current clinical applications of platelet-rich plasma in various gynecological disorders: an appraisal of theory and practice. Clin Exp Reprod Med. 2018;45:67–74.PubMedPubMedCentralCrossRef
17.
Zurück zum Zitat Dhurat R, Sukesh MS. Principles and methods of preparation of platelet-rich plasma: a review and author’s perspective. J Cutan Aesthet Surg. 2014;7:189–97.PubMedPubMedCentralCrossRef Dhurat R, Sukesh MS. Principles and methods of preparation of platelet-rich plasma: a review and author’s perspective. J Cutan Aesthet Surg. 2014;7:189–97.PubMedPubMedCentralCrossRef
18.
19.
Zurück zum Zitat Kamath M, Mascarenhas M, Franik S, Liu E, Sunkara K. Clinical adjuncts in in vitro fertilization: a growing list. Fertil Steril. 2019:1–9. Kamath M, Mascarenhas M, Franik S, Liu E, Sunkara K. Clinical adjuncts in in vitro fertilization: a growing list. Fertil Steril. 2019:1–9.
20.
Zurück zum Zitat Cavallo C, Roffi A, Grigolo B, Mariani E, Pratelli L, Merli G, et al. Platelet-rich plasma: the choice of activation method affects the release of bioactive molecules. BioMed Research International. 2016;2016:1–7.CrossRef Cavallo C, Roffi A, Grigolo B, Mariani E, Pratelli L, Merli G, et al. Platelet-rich plasma: the choice of activation method affects the release of bioactive molecules. BioMed Research International. 2016;2016:1–7.CrossRef
21.
Zurück zum Zitat Chang Y, Li J, Wei L, Pang J, Chen J, Liang X. Autologous platelet-rich plasma infusion improves clinical pregnancy rate in frozen embryo transfer cycles for women with thin endometrium. Medicine. 2019;98:1–5. Chang Y, Li J, Wei L, Pang J, Chen J, Liang X. Autologous platelet-rich plasma infusion improves clinical pregnancy rate in frozen embryo transfer cycles for women with thin endometrium. Medicine. 2019;98:1–5.
22.
Zurück zum Zitat Frantz N, Ferreira M, Kulmann M, Frantz G, Bos-Mikich A, Oliveira R. Platelet-rich plasma as an effective alternative approach for improving endometrial receptivity-a clinical retrospective study. JBRA Assist Reprod. 2020:1–5. Frantz N, Ferreira M, Kulmann M, Frantz G, Bos-Mikich A, Oliveira R. Platelet-rich plasma as an effective alternative approach for improving endometrial receptivity-a clinical retrospective study. JBRA Assist Reprod. 2020:1–5.
23.
Zurück zum Zitat Zadehmodarres S, Salehpour S, Saharkhiz N, Nazari L. Treatment of thin endometrium with autologous platelet-rich plasma: a pilot study. JBRA Assit Reprod. 2017;21:54–6. Zadehmodarres S, Salehpour S, Saharkhiz N, Nazari L. Treatment of thin endometrium with autologous platelet-rich plasma: a pilot study. JBRA Assit Reprod. 2017;21:54–6.
24.
Zurück zum Zitat Tandulwadkar S, Naralkar M, Surana D, Selvakarthick M, Kharat A. Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: a pilot study. J Hum Reprod Sci. 2017;10:208–12.PubMedPubMedCentralCrossRef Tandulwadkar S, Naralkar M, Surana D, Selvakarthick M, Kharat A. Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: a pilot study. J Hum Reprod Sci. 2017;10:208–12.PubMedPubMedCentralCrossRef
26.
Zurück zum Zitat Nazari L, Salehpour S, Hosseini M, Moghanjoughi M. The effects of autologous platelet-rich plasma in repeated implantation failure: a randomized controlled trial. Hum Fertil. 2018:1–6. Nazari L, Salehpour S, Hosseini M, Moghanjoughi M. The effects of autologous platelet-rich plasma in repeated implantation failure: a randomized controlled trial. Hum Fertil. 2018:1–6.
27.
Zurück zum Zitat Sills E, Rickers N, Li X, Palermo G. First data on in vitro fertilization and blastocyst formation after intraovarian injection of calcium gluconate-activated autologous platelet rich plasma. Gynecol Endocrinol. 2018;34:756–60.PubMedCrossRef Sills E, Rickers N, Li X, Palermo G. First data on in vitro fertilization and blastocyst formation after intraovarian injection of calcium gluconate-activated autologous platelet rich plasma. Gynecol Endocrinol. 2018;34:756–60.PubMedCrossRef
28.
Zurück zum Zitat Sfakianoudis K, Simopoulou M, Nitsos N, Rapani A, Pantou A, Vaxevanoglou T, et al. A case series on platelet-rich plasma revolutionary management of poor responder patients. Gynecol Obstet Invest. 2018;84:99–106.PubMedCrossRef Sfakianoudis K, Simopoulou M, Nitsos N, Rapani A, Pantou A, Vaxevanoglou T, et al. A case series on platelet-rich plasma revolutionary management of poor responder patients. Gynecol Obstet Invest. 2018;84:99–106.PubMedCrossRef
29.
Zurück zum Zitat Cakiroglu Y, Saltik A, Yuceturk A, Karaosmanoglu O, Kopuk S, Scott R, et al. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency. Aging. 2020;12:10211–22.PubMedPubMedCentralCrossRef Cakiroglu Y, Saltik A, Yuceturk A, Karaosmanoglu O, Kopuk S, Scott R, et al. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency. Aging. 2020;12:10211–22.PubMedPubMedCentralCrossRef
30.
Zurück zum Zitat Hsu C, Hsu L, Hsu I, Chiu Y, Dorjee S. Live birth in woman with premature ovarian insufficiency receiving ovarian administration of platelet-rich plasma (PRP) in combination with gonadotropin: a case report. Front Endocrinol. 2020;11:1–5.CrossRef Hsu C, Hsu L, Hsu I, Chiu Y, Dorjee S. Live birth in woman with premature ovarian insufficiency receiving ovarian administration of platelet-rich plasma (PRP) in combination with gonadotropin: a case report. Front Endocrinol. 2020;11:1–5.CrossRef
31.
Zurück zum Zitat Melo P, Navarro C, Jones C, Coward K, Coleman L. The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non-randomized interventional study. J Assist Reprod Genet. 2020;37:855–63.PubMedPubMedCentralCrossRef Melo P, Navarro C, Jones C, Coward K, Coleman L. The use of autologous platelet-rich plasma (PRP) versus no intervention in women with low ovarian reserve undergoing fertility treatment: a non-randomized interventional study. J Assist Reprod Genet. 2020;37:855–63.PubMedPubMedCentralCrossRef
32.
Zurück zum Zitat Sills SE, Rickers NS, Petersen JL, Li X, Wood SH. Regenerative effect of intraovarian injection of activated autologous platelet rich plasma: serum anti-mullerian hormone levels measured among poor-prognosis in vitro fertilization patients. Int J Regen Med. 2020;1(2):2–5. Sills SE, Rickers NS, Petersen JL, Li X, Wood SH. Regenerative effect of intraovarian injection of activated autologous platelet rich plasma: serum anti-mullerian hormone levels measured among poor-prognosis in vitro fertilization patients. Int J Regen Med. 2020;1(2):2–5.
33.
Zurück zum Zitat Sills E, Wood S. Autologous activated platelet-rich plasma injection into adult human ovary tissue: molecular mechanism, analysis, and discussion of reproductive response. Biosci Rep. 2019;39:1–15.CrossRef Sills E, Wood S. Autologous activated platelet-rich plasma injection into adult human ovary tissue: molecular mechanism, analysis, and discussion of reproductive response. Biosci Rep. 2019;39:1–15.CrossRef
34.
Zurück zum Zitat Stojkovska S, Dimitrov G, Stamenkovska N, Hadzi-Lega M, Petanovski Z. Live birth rates in poor responders’ group after previous treatment with autologous platelet-rich plasma and low dose ovarian stimulation compared with poor responders used only low dose ovarian stimulation before in vitro fertilization. J Med Sci. 2019;7:3184–8. Stojkovska S, Dimitrov G, Stamenkovska N, Hadzi-Lega M, Petanovski Z. Live birth rates in poor responders’ group after previous treatment with autologous platelet-rich plasma and low dose ovarian stimulation compared with poor responders used only low dose ovarian stimulation before in vitro fertilization. J Med Sci. 2019;7:3184–8.
35.
Zurück zum Zitat Mehrafza M, Kabodmehri R, Nikpouri Z, Pourseify G, Raoufi A, Eftekhari A, et al. Comparing the impact of autologous platelet-rich plasma and granulocyte colony stimulating factor on pregnancy outcome in patients with repeated implantation failure. J Reprod Infertil. 2019;20:35–41.PubMedPubMedCentral Mehrafza M, Kabodmehri R, Nikpouri Z, Pourseify G, Raoufi A, Eftekhari A, et al. Comparing the impact of autologous platelet-rich plasma and granulocyte colony stimulating factor on pregnancy outcome in patients with repeated implantation failure. J Reprod Infertil. 2019;20:35–41.PubMedPubMedCentral
36.
Zurück zum Zitat Sfakianoudis K, Simopoulou M, Nitsos N, Lazaros L, Rapani A, Pantou A, et al. Successful implantation and live birth following autologous platelet-rich plasma treatment for a patient with recurrent implantation failure and chronic endometritis. In Vivo. 2019;33:515–21.PubMedPubMedCentralCrossRef Sfakianoudis K, Simopoulou M, Nitsos N, Lazaros L, Rapani A, Pantou A, et al. Successful implantation and live birth following autologous platelet-rich plasma treatment for a patient with recurrent implantation failure and chronic endometritis. In Vivo. 2019;33:515–21.PubMedPubMedCentralCrossRef
37.
Zurück zum Zitat Aghajanzadeh F, Esmaeilzadeh S, Basirat Z, Mahouti T, Heidari F, Golsorkhtabaramiri M. Using autologous intrauterine platelet-rich plasma to improve the reproductive outcomes of women with recurrent implantation failure. JBRA Assist. Reprod. 2020;24:30–3.PubMedPubMedCentral Aghajanzadeh F, Esmaeilzadeh S, Basirat Z, Mahouti T, Heidari F, Golsorkhtabaramiri M. Using autologous intrauterine platelet-rich plasma to improve the reproductive outcomes of women with recurrent implantation failure. JBRA Assist. Reprod. 2020;24:30–3.PubMedPubMedCentral
38.
Zurück zum Zitat Zargar M, Pazhouhanfar R, Najafian M, Moradi CP. Effects of intrauterine autologous platelet-rich plasma infusions on outcomes in women with repetitive in vitro fertilization failures: a prospective randomized study. Clinical Experimental Obstet Gynecol. 2021;48(1):179–84.CrossRef Zargar M, Pazhouhanfar R, Najafian M, Moradi CP. Effects of intrauterine autologous platelet-rich plasma infusions on outcomes in women with repetitive in vitro fertilization failures: a prospective randomized study. Clinical Experimental Obstet Gynecol. 2021;48(1):179–84.CrossRef
Metadaten
Titel
A narrative review of platelet-rich plasma (PRP) in reproductive medicine
verfasst von
Fady I. Sharara
Latashia-Lika Lelea
Sara Rahman
Jordan S. Klebanoff
Gaby N. Moawad
Publikationsdatum
15.03.2021
Verlag
Springer US
Erschienen in
Journal of Assisted Reproduction and Genetics / Ausgabe 5/2021
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI
https://doi.org/10.1007/s10815-021-02146-9

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