Platelet-rich plasma infusion into the uterus for IVF

What is Platelet-rich plasma infusion into the uterus for IVF?

Platelet-rich plasma (PRP) for IVF involves infusing a patient’s blood, processed to have a high level of platelets, into the uterus.

• Platelet-rich plasma (PRP) is made from a patient’s own blood and contains a higher concentration of blood platelets than normal blood.
• Plasma is the liquid part of blood and platelets are cells in blood that help with blood clotting and healing.
• Platelets produce growth factors and cytokines (small proteins) which help with blood clotting and healing of damaged blood vessels and tissues.
• To create PRP, a blood sample is spun in a machine called a centrifuge to concentrate the platelets.
• In the context of IVF, PRP may be administered in two ways: injection into the ovary or infusion into the uterus. This information is about PRP infusion or instillation into the uterus, sometimes referred to as a ‘PRP wash’ or ‘PRP flush’ (we also cover injection of PRP into the ovaries).

Why might infusion of PRP into the uterus improve IVF outcomes?

• The concentrated presence of platelets may help to increase the thickness of the endometrium (lining of the uterus).
• The growth factors and cytokines in PRP may help to heal and ‘rejuvenate’ the endometrium, and to reduce any inflammation.

Why might infusion of PRP into the uterus not improve IVF outcomes?

• The endometrium is naturally supplied by blood that contains a normal concentration of platelets. Additional platelets from PRP may not offer any benefit. It is possible that an increase in platelets and cytokines could actually be detrimental. If someone already has a healthy balance of platelets and cytokines, adding more might upset this balance. Instead of helping, it could interfere with the natural environment of the uterus and potentially reduce the chances of IVF success.
• It is important to remember that implantation failure is common - most embryo transfers do not result in pregnancy. Most of the time when embryos fail to implant it is due to genetic or chromosomal problems in the embryo itself, rather than issues with the endometrial lining. Therefore, PRP may not be expected to make much difference to the chance of successful implantation.

Who might consider infusion of PRP into the uterus for IVF?

People who have experienced issues with

• Thin endometrium (lining of the uterus)
• Recurrent implantation failure

Does infusion of PRP into the uterus for IVF work? What the evidence says

Only four small randomised trials were included. The trials had limited data and serious limitations or flaws that could bias their results. Therefore, it is unclear whether infusion of PRP into the uterus has any effect on the chance of live birth, pregnancy, or miscarriage. Many of the trials identified had to be excluded for trustworthiness concerns (see excluded studies below).

Side effects of PRP infusion into the uterus

• A small amount of cramping, pain or discomfort during or following the procedure.
• A small amount of bleeding during or after the procedure.
• All procedures carry a small risk of infection, but this is extremely rare.
• Hypersensitivity or inflammatory reactions can result from any prepared blood product, but these are very rare. The symptoms of these reactions are diverse and range from skin conditions to anaphylaxis.

All medical procedures carry some risk. PRP infusion into the uterus is a new optional extra, and there is not much information available about possible side-effects of this procedure.

Risks of PRP infusion into the uterus and long-term outcomes

It is unknown whether there are any risks or long-term harms from PRP infusion into the uterus

• This is based on data from randomised controlled trials and input from IVF specialists. Possible risks of harm and long-term outcomes are often not reported in randomised trials and therefore it is unknown whether PRP poses any risk of harm to the IVF patient or the embryo/baby.

PRP infusion has been used in Australia since 2019, and approximately 500 IVF cycles have used PRP infusion into the uterus.

Cost of PRP infusion into the uterus for IVF

Platelet rich plasma (PRP) usually costs between $800-1,500 AUD per infusion. Multiple infusions may be recommended.

Cost information is indicative only, costs can vary from clinic to clinic and depending on different circumstances.

Practical considerations about PRP infusion into the uterus

PRP treatment procedure – uterine infusion

• Drawing blood
  • The IVF patient has a blood sample taken – just like a regular blood test.
• Separating platelets
  • The blood is placed in a centrifuge machine which spins the blood rapidly, to produce a sample of plasma that is rich in platelets.
• Infusing the PRP
  • The PRP is then infused into the uterus. A speculum is placed inside the vagina. Then a thin plastic catheter is inserted through the cervix and into the uterus. The PRP is then infused into the uterus. PRP infusion into the uterus usually takes place 1-3 days before an embryo transfer. The procedure is like an embryo transfer procedure and takes approximately 5-10 minutes.

Unsure about some of the terms we have used? Use our glossary to understand scientific or unfamiliar terms.