PRP therapy for Uterine lining rejuvenation
If you have gone through repeated lines of IVF and implantation failure, or you have been prepared for Transfer multiple times and the transferred was cancelled in the last minute because the endometrium was not ready. Have you ever wondered why? Does the thickness of endometrial lining effects implantation success after Transfer? How does thin endometrium lining effect IVF success rate? Let’s us explore what causes thin endometrium lining and the effectivity of PRP therapy for thin endometrium lining. Can it help in uterine lining rejuvenation and improve IVF success rate?
Role of endometrial lining in Implantation success rate.
Good endometrium lining thickness and endometrial receptivity is one of the main factors that influence implantation success and achieving pregnancy after embryo transfer. Studies have proved that thin endometrium lining during IVF affects the implantation and is the cause behind failure of the embryo to implant after transfer. This is the reason why transfers are cancelled frequently if the endometrium lining doesn’t achieve the desired thickness.
So what Causes Thin endometrium?
Thin endometrium can be caused by various factors, but the most common reasons are:
- Uterine Infections and inflammations can be responsible for an unresponsive endometrium after conventional therapy. This event is relatively frequent in
- Women who have previously suffered trauma of the uterus like previous cesarean sections, repetitive curettage,
- Women affected by Asher man’s syndrome
- Women with chronic infections, endometritis, Pelvic Inflammatory Disease) and inadequate blood flow (stress, malposition of uterus
- Low estradiol values and excessive use of Clomiphene Citrate are other causes of thin endometrium, given the ant estrogenic effect of the latter
- Fibrosis of Uterus, which takes place also during acute or chronic infections, is at the base of tissue healing and causes the destruction of the basal layer of the endometrium, also narrowing the uterine cavity. When the basal layer is damaged by fibrosis, regeneration of endometrium is very difficult.
- Uterine Surgeries, such as reiterated curettage, intracavitary myomectomy and polypectomy may lead to intrauterine adhesions and damage the endometrium via the same mechanism.
- Cancer treatments, such as radical surgery, chemotherapy and radiotherapy (RT) can permanently affect present or future reproductive function both in males and females.
Effective Treatment option for Thin Endometrium lining:
Endometrium thickness less than 7 mm is considered thin endometrium and will negatively impact of the IVF success rate. It has been seen that women who are undergoing IVF treatment or FET, if the endometrium thickness is less than 7mm, Pregnancy is unlikely. This necessitates the need for treatment strategies on how to improve thin endometrium lining before Transfer. One of the current strategies for improving the receptivity and thickness of endometrial lining is by Intrauterine Infusion of Platelet Rich Plasma.
PRP contains activating platelets that stimulate action of cytokines and growth factors. They can regulate cell migration, attachment, proliferation and differentiation, and promote extracellular matrix accumulation. According to this theory, local infusion of PRP (that contains several growth factors and cytokines) may improve endometrial receptivity and implantation - Chang et al. (2).
Results of a recent study (1) on the effect of PRP on Endometrial cell proliferation (presented at the American Society for Reproductive Medicine (ASRM) conference in Oct 2016) has established that PRP increased the proliferation not only on cultured fibroblasts, as currently known, but also on mesenchymal cells, which are progenitors of different types of cells, including endometrial cells. This evidence stands positively in supports the belief that PRP can stimulates some of the cellular processes involved in endometrial regeneration thus making it an effective treatment therapy for the management of a thin lining.
So how effective is PRP therapy for Improving the Endometrium lining and IVF success results?
Results of a study on the effectively of PRP therapy on Thin endometrial lining [by Chang et al. (2)], has been encouraging as all the 5 patients who participated in this therapy responded with successful thickening of endometrium following intra uterine infusion of PRP and all of them conceived.
Another study by Nazari et al. (3) gives supportive evidence that PRP is quite effective in improving pregnancy outcome in patients with Repeated Implantation Failure (RIF). 16 out of the twenty women who received intra-uterine PRP transfusion 48 hours before transfer were pregnant.
How is intrauterine infusion of PRP procedure done?Intrauterine infusion of PRP must be done 48 hours before ET.
Patients are first tested to rule out blood disorders or platelet dysfunction.
- The following are relative contraindications for PRP application: platelet count less than 105/μL, hemoglobin level less than 10 g/dL, presence of a blood tumor or metastatic disease, and other concomitant infections (64).
- Autologous Platelet-Rich Plasma is prepared from fresh whole blood which is collected from a peripheral vein and processed to separate platelets from the other blood components
PRP is obtained from autologous blood on the 10th day of ART cycle, 8 ml of venous blood is drawn from the pre-filled syringe, and centrifuged immediately at 1500g (RCF) for 10 min. The repeated reversal of the tube allows to obtain the quantitative of PRP at the concentration required. PRP must be infused into the uterus cavity immediately via a catheter (0.5–1 ml) Endometrial thickness is re-assessed 48–72 h later. If the endometrial thickness is not satisfying, infusion of PRP can be performed 1–2 times more.
PRP therapy for Uterine Rejuvenation in Kolkata
Renovaré Clinic Kolkata offers PRP therapy for uterine lining Improvement in India, for women who are unable to conceive due to poor endometrial receptivity or have undergone repetitive IVF failure due to thin endometrial lining.
Dr. Rajeev Agarwal is one of the first infertility specialists in Kolkata to introduce Platelet rich plasma therapy for endometrial rejuvenation at Renovaré clinic in kolkata, India.
Book appointment with Dr. Rajeev Agarwal for PRP treatment for ovarian rejuvenation in Kolkata,