Subendometrial Platelet-Rich Plasma at Time of Hysteroscopy Improves Endometrial Thickness and Cavity Characteristics in Patients with Thin Endometrium

Objective: To evaluate the effect of subendometrial platelet-rich plasma (PRP) administered at the time of hysteroscopy on endometrial thickness and uterine cavity characteristics. Design: Retrospective cohort study. Materials and Methods: Nine patients who underwent hysteroscopy with subendometrial PRP were included. Indications for treatment included thin endometrium and Asherman syndrome. Endometrial thickness (ES), trilaminar pattern, and intrauterine fluid were compared before and after PRP prior to embryo transfer attempts. Results: Endometrial thickness improved in 8 of 9 patients (89%), with mean thickness increasing from 6.1 mm pre-PRP to 8.1 mm post-PRP. Several patients demonstrated clinically meaningful, including increases from 7.03 mm to 12.78 mm and from 5.10 mm to 8.96 mm. Endometrial pattern also improved following treatment. 5 of 9 patients lacked a trilaminar pattern prior to PRP, compared to 0 of 9 after PRP, with all patients demonstrating a trilaminar pattern post-treatment. Intrauterine fluid was present in 2 patients before PRP and resolved in both cases following treatment. These improvements occurred despite similar or fewer days of estrogen exposure in multiple patients. Conclusions: Subendometrial PRP administered at the time of hysteroscopy was associated with improved endometrial thickness, restoration of trilaminar pattern, and resolution of intrauterine fluid in patients with thin endometrium or intrauterine pathology. This approach may represent a useful adjunct for optimizing the endometrium prior to embryo transfer.