PLATELET-RICH PLASMA FOR ENDOMETRIAL MODULATION IN INFERTILE WOMEN UNDERGOING ASSISTED REPRODUCTIVE TECHNOLOGY: A SCOPING REVIEW
- 1Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
- 2Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil; Universidade Federal Fluminense (UFF), Rio de Janeiro, RJ, Brazil
Abstract
Background: Platelet-rich plasma (PRP) is an autologous blood-derived product containing concentrated platelets and bioactive mediators that promote tissue repair, angiogenesis, and immunomodulation. In assisted reproductive technology (ART), PRP has emerged as a potential adjunct to improve endometrial receptivity in women with infertility. Objective: To map and characterize the scientific evidence regarding PRP for endometrial modulation in infertile women undergoing ART. Methods: A scoping review was conducted according to the Joanna Briggs Institute methodology and reported following PRISMA-ScR guidelines. Searches were performed in February 2025 in PubMed/MEDLINE, Web of Science, SciELO, and Google Scholar. Studies evaluating intrauterine or endometrial PRP administration in infertile women undergoing ART were included. Two reviewers independently performed study selection and data extraction using Rayyan®. Results: Among 693 identified records, 67 studies (2016–2025) were included. The predominant designs were narrative reviews (22.4%; n=15), randomized controlled trials (20.9%; n=14), and systematic reviews with meta-analyses (19.4%; n=13). The main indications were recurrent implantation failure (46.2%; n=31), thin endometrium (38.0%; n=26), Asherman's syndrome (16.4%; n=11), and chronic endometritis or other endometrial disorders (12.0%; n=8). Intrauterine infusion was reported in >90% of studies, most commonly using 0.5–4.0 mL of autologous PRP administered as a single application (43%) or in two to three applications (37%). Most studies described endometrial thickening of 1–3 mm, frequently enabling embryo transfer in previously cancelled cycles. Meta-analyses reported higher implantation (RR 1.7–1.8), clinical pregnancy (RR 1.8–2.0), and live birth rates (RR=2.92). Histological and molecular analyses demonstrated improved vascularization and increased expression of endometrial receptivity markers (HOXA10 and leukemia inhibitory factor). No severe PRP-related adverse events were reported. Discussion: Overall, the evidence supports a potential regenerative role of PRP in endometrial remodeling. However, substantial heterogeneity was identified regarding PRP preparation, platelet concentration, leukocyte content, activation strategy, centrifugation protocol, administered volume, treatment schedule, and timing of infusion. These methodological differences, together with the predominance of observational studies, small sample sizes, inconsistent diagnostic criteria, and limited long-term reproductive follow-up, substantially reduce comparability and certainty of the available evidence. Conclusion: PRP is a promising autologous blood product for endometrial modulation in ART, particularly in women with thin endometrium and recurrent implantation failure. Nevertheless, standardized PRP manufacturing and characterization protocols, together with adequately powered multicenter randomized trials using clinically relevant reproductive endpoints, remain essential before routine clinical implementation.
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BibTeX
@article{kienteca2026plateletrich,
title = {{PLATELET-RICH PLASMA FOR ENDOMETRIAL MODULATION IN INFERTILE WOMEN UNDERGOING ASSISTED REPRODUCTIVE TECHNOLOGY: A SCOPING REVIEW}},
author = {Nicole Guimarães KIENTECA and Júlia Grossi PAIVA and Andrezza Do Espirito Santo CUCINELLI},
journal = {Hematology, Transfusion and Cell Therapy},
year = {2026},
month = oct,
doi = {10.1016/j.htct.2026.108120},
url = {https://doi.org/10.1016/j.htct.2026.108120},
note = {CC BY},
}
RIS
TY - JOUR
TI - PLATELET-RICH PLASMA FOR ENDOMETRIAL MODULATION IN INFERTILE WOMEN UNDERGOING ASSISTED REPRODUCTIVE TECHNOLOGY: A SCOPING REVIEW
AU - Nicole Guimarães KIENTECA
AU - Júlia Grossi PAIVA
AU - Andrezza Do Espirito Santo CUCINELLI
PY - 2026
DA - 2026/10/23
JO - Hematology, Transfusion and Cell Therapy
DO - 10.1016/j.htct.2026.108120
UR - https://doi.org/10.1016/j.htct.2026.108120
AB - Background: Platelet-rich plasma (PRP) is an autologous blood-derived product containing concentrated platelets and bioactive mediators that promote tissue repair, angiogenesis, and immunomodulation. In assisted reproductive technology (ART), PRP has emerged as a potential adjunct to improve endometrial receptivity in women with infertility. Objective: To map and characterize the scientific evidence regarding PRP for endometrial modulation in infertile women undergoing ART. Methods: A scoping review was conducted according to the Joanna Briggs Institute methodology and reported following PRISMA-ScR guidelines. Searches were performed in February 2025 in PubMed/MEDLINE, Web of Science, SciELO, and Google Scholar. Studies evaluating intrauterine or endometrial PRP administration in infertile women undergoing ART were included. Two reviewers independently performed study selection and data extraction using Rayyan®. Results: Among 693 identified records, 67 studies (2016–2025) were included. The predominant designs were narrative reviews (22.4%; n=15), randomized controlled trials (20.9%; n=14), and systematic reviews with meta-analyses (19.4%; n=13). The main indications were recurrent implantation failure (46.2%; n=31), thin endometrium (38.0%; n=26), Asherman's syndrome (16.4%; n=11), and chronic endometritis or other endometrial disorders (12.0%; n=8). Intrauterine infusion was reported in >90% of studies, most commonly using 0.5–4.0 mL of autologous PRP administered as a single application (43%) or in two to three applications (37%). Most studies described endometrial thickening of 1–3 mm, frequently enabling embryo transfer in previously cancelled cycles. Meta-analyses reported higher implantation (RR 1.7–1.8), clinical pregnancy (RR 1.8–2.0), and live birth rates (RR=2.92). Histological and molecular analyses demonstrated improved vascularization and increased expression of endometrial receptivity markers (HOXA10 and leukemia inhibitory factor). No severe PRP-related adverse events were reported. Discussion: Overall, the evidence supports a potential regenerative role of PRP in endometrial remodeling. However, substantial heterogeneity was identified regarding PRP preparation, platelet concentration, leukocyte content, activation strategy, centrifugation protocol, administered volume, treatment schedule, and timing of infusion. These methodological differences, together with the predominance of observational studies, small sample sizes, inconsistent diagnostic criteria, and limited long-term reproductive follow-up, substantially reduce comparability and certainty of the available evidence. Conclusion: PRP is a promising autologous blood product for endometrial modulation in ART, particularly in women with thin endometrium and recurrent implantation failure. Nevertheless, standardized PRP manufacturing and characterization protocols, together with adequately powered multicenter randomized trials using clinically relevant reproductive endpoints, remain essential before routine clinical implementation.
SN - 2531-1379
SN - 2531-1387
ER -