The value of platelet-rich plasma in women with previous implantation failure: a systematic review and meta-analysis

Objective To assess the value of intrauterine PRP to improve IVF outcome in women with previous implantation failure. Methods Screening of Pubmed, Web of Science, and other databases from inception to August 2022 using the keywords related to “platelet-rich plasma” OR “PRP” AND “IVF” “implantation failure.” Twenty-nine studies (3308 participants) were included in our analysis, 13 were RCTs, 6 were prospective cohorts, 4 were prospective single arm, and 6 were retrospective analyses. Extracted data included settings of the study, study type, sample size, participants’ characteristics, route, volume, timing of PRP administration, and outcome parameters. Results Implantation rate was reported in 6 RCTs (886 participants) and 4 non-RCTs (732 participants). The odds ratio (OR) effect estimate was 2.62 and 2.06, with 95% CI of 1.83, 3.76, and 1.03–4.11, respectively. Endometrial thickness was compared in 4 RCTs (307 participants) and 9 non-RCTs (675 participants), which showed a mean difference of 0.93 and 1.16, with 0.59–1.27 and 0.68–1.65 95% CI, respectively. Conclusion PRP administration improves implantation, clinical pregnancy, chemical pregnancy, ongoing pregnancy, live birth rates, and endometrial thickness in women with previous implantation failure.