Subendometrial Platelet-Rich Plasma Improves Embryo Transfer Feasibility and Pregnancy Outcomes in Patients With Poor Endometrial Development

Objective: To assess whether subendometrial PRP administered at hysteroscopy improves embryo transfer rates and clinical outcomes. Design: Retrospective cohort study. Materials and Methods: Nine patients undergoing hysteroscopy with PRP were evaluated. Outcomes included ability to proceed with embryo transfer, biochemical pregnancy, and miscarriage rates before and after intervention. Results: Prior to PRP, 2 of 9 patients (22%) proceeded to embryo transfer. Following PRP, 7 of 9 patients (78%) underwent embryo transfer. Among patients undergoing transfer post-PRP (n = 7), 3 (43%) achieved a positive pregnancy test. Of these, 2 resulted in ongoing pregnancies and 1 resulted in miscarriage. Importantly, patients previously unable to proceed to transfer due to inadequate endometrial development or cavity abnormalities were able to undergo transfer following PRP, including those with Asherman syndrome and intrauterine fluid. Conclusions: Subendometrial PRP may improve the likelihood of proceeding to embryo transfer and may be associated with favorable pregnancy outcomes in patients with poor endometrial receptivity. These findings support further investigation in larger, prospective studies.