Platelet-Rich Plasma (PRP) therapy is a form of regenerative medicine that utilizes a patient’s own blood components to stimulate healing and tissue repair. This approach concentrates platelets, which are rich in growth factors, into a small volume of plasma. In reproductive medicine, PRP fertility treatment is an emerging therapy being explored as an adjunctive method to address certain infertility challenges. It represents a novel, non-hormonal strategy that aims to improve the biological environment of reproductive organs.
The Biological Mechanism of PRP
The therapeutic action of PRP begins with the preparation process, where a sample of the patient’s whole blood is collected. This sample is then spun in a specialized machine called a centrifuge, which separates the blood components based on their density. This process isolates the plasma containing a high concentration of platelets, typically enriching them to three to five times their normal physiological levels.
Platelets contain intracellular structures called alpha granules that store a variety of bioactive molecules. Once injected into the target tissue, these activated platelets release a potent mixture of growth factors and cytokines. These released factors act as powerful cellular signals to initiate a natural healing cascade.
Specific components, such as Platelet-Derived Growth Factor (PDGF), Vascular Endothelial Growth Factor (VEGF), and Transforming Growth Factor-beta (TGF-β), are among the most active molecules. PDGF and TGF-β promote cellular proliferation and the repair of damaged tissue structures. VEGF stimulates angiogenesis, the formation of new blood vessels, which improves blood supply and oxygen delivery to the treated area. This combined effect is the core mechanism proposed to regenerate reproductive tissues and improve their function.
Specific Applications in Female Fertility
PRP is currently being investigated for its potential to address two distinct areas of female infertility. The primary application is ovarian rejuvenation, targeting women experiencing diminished ovarian reserve (DOR) or premature ovarian insufficiency (POI). Intraovarian injection of PRP is theorized to activate dormant follicles and encourage the development of existing egg cells.
Early studies suggest this treatment can lead to measurable changes in ovarian function, such as an increase in Anti-Müllerian Hormone (AMH) levels and Antral Follicle Count (AFC) in some patients. The goal is to improve the quantity and quality of oocytes available for natural conception or assisted reproductive technologies like in vitro fertilization (IVF).
The second significant application involves endometrial preparation for women with a thin uterine lining, a condition often associated with recurrent implantation failure. For these patients, an intrauterine infusion of PRP aims to promote the growth and receptivity of the endometrium. The growth factors stimulate the proliferation of endometrial cells, helping the lining reach the optimal thickness, usually considered greater than seven millimeters, creating a more favorable environment for an implanted embryo.
The Patient Procedure and Administration
The PRP procedure begins with a standard blood draw from the patient’s arm, collecting a volume similar to routine laboratory tests. This blood is immediately processed using a specialized centrifugation system to separate the platelet-rich component. The preparation stage is brief, usually taking 15 to 30 minutes, resulting in a concentrated solution ready for immediate use.
The method of administration is determined by the specific fertility issue being addressed. For ovarian rejuvenation, the PRP is injected directly into the ovaries using a thin needle guided by transvaginal ultrasound, similar to an egg retrieval procedure.
When treating a thin endometrial lining, the PRP is administered as an intrauterine infusion. In this less invasive procedure, the concentrated plasma is gently instilled directly into the uterine cavity through a thin catheter. The precise timing of this infusion is coordinated with the patient’s menstrual cycle or hormonal preparation for an embryo transfer.
Current Clinical Evidence and Regulatory Status
Despite the encouraging biological theory, PRP fertility treatment remains an experimental and investigational therapy. The current scientific support consists largely of case reports, small cohort studies, and meta-analyses of limited trials. While these studies frequently report positive outcomes, such as increases in ovarian reserve markers and improved endometrial thickness, results are inconsistent due to variations in patient populations and treatment protocols.
A significant limitation is the absence of large-scale, randomized controlled trials (RCTs), which are necessary to definitively establish efficacy and standardized treatment practices. Furthermore, the lack of standardization in PRP preparation protocols, including optimal concentration and activation methods, contributes to the variability of outcomes observed across different clinics.
Regarding its regulatory standing, PRP is not classified as a drug by the U.S. Food and Drug Administration (FDA) because it is derived from the patient’s own blood. While the devices used to prepare the plasma are subject to FDA clearance, the use of PRP for fertility purposes is not specifically approved for this indication. Consequently, any application of PRP for ovarian or endometrial treatment is considered “off-label,” requiring patients to consult with a fertility specialist about the investigational nature of the therapy.