The role of platelet-rich plasma in repeated implantation failure: a review of biological mechanisms and clinical efficacy.
- 1Department of Obstetrics and Gynecology, Medical School, University of Crete, Herakleion, Crete, Greece.
- 2Department of Histology, Medical School, University of Crete, Herakleion, Crete, Greece.
Abstract
Repeated implantation failure (RIF) remains a significant challenge in assisted reproductive technology, with approximately two-thirds of cases attributed to impaired endometrial receptivity. This review highlights the role of autologous platelet-rich plasma (PRP) as a regenerative adjuvant for rehabilitating the uterine environment. Molecular mechanisms and clinical evidence are presented. It is evident that the concentrated growth factors in PRP-such as VEGF, PDGF, and TGF-beta-promote cell proliferation, angiogenesis, immunomodulation and tissue remodeling. Α consistent statistical trend is recognized toward improved clinical pregnancy and live birth rates across multiple meta-analyses. However, a critical methodological-clinical gap is identified, noting that the current evidence base is compromised by a high risk of bias, non-standardized preparation protocols, and inconsistent diagnostic criteria for RIF. While PRP shows significant biological promise in transforming a hostile uterine environment into a receptive one, its routine clinical application is currently cautioned. Until large-scale, properly blinded randomized controlled trials -utilizing standardized ESHRE definitions- are conducted, PRP should be regarded as an experimental tool rather than a validated standard of care.
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BibTeX
@article{makrygiannakis2026role,
title = {{The role of platelet-rich plasma in repeated implantation failure: a review of biological mechanisms and clinical efficacy.}},
author = {Fanourios Makrygiannakis and Thomas Vrekoussis and Maria Marmara and Aikaterini Berdiaki and Antonis Makrigiannakis},
journal = {Frontiers in reproductive health},
year = {2026},
month = oct,
doi = {10.3389/frph.2026.1907558},
url = {https://europepmc.org/article/MED/42923818},
note = {CC BY},
}
RIS
TY - JOUR
TI - The role of platelet-rich plasma in repeated implantation failure: a review of biological mechanisms and clinical efficacy.
AU - Fanourios Makrygiannakis
AU - Thomas Vrekoussis
AU - Maria Marmara
AU - Aikaterini Berdiaki
AU - Antonis Makrigiannakis
PY - 2026
DA - 2026/10/08
JO - Frontiers in reproductive health
DO - 10.3389/frph.2026.1907558
UR - https://europepmc.org/article/MED/42923818
AB - Repeated implantation failure (RIF) remains a significant challenge in assisted reproductive technology, with approximately two-thirds of cases attributed to impaired endometrial receptivity. This review highlights the role of autologous platelet-rich plasma (PRP) as a regenerative adjuvant for rehabilitating the uterine environment. Molecular mechanisms and clinical evidence are presented. It is evident that the concentrated growth factors in PRP-such as VEGF, PDGF, and TGF-beta-promote cell proliferation, angiogenesis, immunomodulation and tissue remodeling. Α consistent statistical trend is recognized toward improved clinical pregnancy and live birth rates across multiple meta-analyses. However, a critical methodological-clinical gap is identified, noting that the current evidence base is compromised by a high risk of bias, non-standardized preparation protocols, and inconsistent diagnostic criteria for RIF. While PRP shows significant biological promise in transforming a hostile uterine environment into a receptive one, its routine clinical application is currently cautioned. Until large-scale, properly blinded randomized controlled trials -utilizing standardized ESHRE definitions- are conducted, PRP should be regarded as an experimental tool rather than a validated standard of care.
SN - 2673-3153
ER -