Endometrial thickness is an important factor inthin endometrium implantation and pregnancy. In several studies, the minimum endometrial thickness for embryo transfer has been reported to be 7 mm. Several approaches have been tried to increase endometrial thickness for frozen-thawed embryo transfer (FET) cyclesbut as yet there is no consensus on the most effective method. Some FET cycles are cancelled due to thin endometrium despite routine treatment, and there is no recognized protocol for increasing the thin endometrium.
Fresh PRP prepared from whole blood, collected from peripheral veins contains several growth factors such as:
Uterine Infections and inflammations, pelvic infectious diseases lead to unresponsiveness to estrogens.
Vascular Endothelial Growth Factor (VEGF),
Platelet-derived growth factor (PDGF),
Transforming Growth Factor (TGF) and other
Cytokines that stimulate proliferation and growth.
PRP has been used in several other medical conditions in e.g. sports injuries, diabetic foot healing, orthopedics, surgery and wound healing but its efficacy in endometrial growth has not been fully elucidated
Hysteroscopic examination is performed before the cycle if it had not been done previously. Hormone replacement therapy (HRT) is started on the day of the cycle for endometrial preparation for IVF cycle Transvaginal ultrasound is performed by an expert gynecologist by one machine. Endometrial thickness is measured at the thickest part in the longitudinal axis of the uterus.
PRP is prepared from patients own blood using a two-step centrifuge process.
On the 9th or 10th day of the menstrual cycle, the blood is processed as follows
5 ml of peripheral venous blood is drawn in the syringe that containing 2.5 ml of Acid Citrate A Anticoagulant solution (ACD-A)
The plasma is centrifuged again at 3300 rpm for 7 min to obtain the PRP.
Then, 0.5 ml of PRP is infused into the uterine cavity with the IUI catheter (as shown above).
This procedure results in endometrial thickening, improved implantation rates and clinical pregnancies.
Patients suffering from chronic thin endometrium can benefit from PRP therapy. The successful implantation depends upon the thickness and close dialog between the blastocyst and the endometrium.
1. Endometrial resistance to circulating estrogen
2. Reduced blood flow to the endometrium
3. Over-exposure to testosterone
4. Permanent damage to the basal endometrium