Received November 17, 2020
Accepted May 20, 2021

Objective: To evaluate whether platelet-rich plasma (PRP) optimizes endometrial thickness (EMT) and improves live birth rate(LBR) in women with refractory thin endometrium due to varied aetiology during fresh in vitro fertilization (IVF) and frozen-thawed embryo transfer (FET). Methods: A prospective interventional study was conducted at ART Centre of tertiary care academic hospital. 22 infertile women with refractory thin endometrium (<7mm) despite standard hormone replacement therapy were assessed. 20 patients underwent 26 PRP cycles from December 2018 - June 2020 during fresh IVF-ET and FET. Primary endpoint was expansion of EMT and secondary outcomes were implantation rate(IR), clinical pregnancy rate(CPR) and LBR in fresh and FET cycles and aetiology wise. Results: Mean EMT increased significantly following PRP administration (p< 0.001) with average increase of 1.07mm and 0.83 mm after first PRP (p<0.001) during fresh IVF and FET respectively. CPR, IR and LBR showed no significant difference when compared during fresh vs. FET cycles ( p>0.05). PRP led to significant increase in EMT in tuberculosis (TB), diminished ovarian reserve (DOR) and polycystic ovary syndrome (PCOS) (p<0.001). There was no significant difference in CPR, IR and LBR among three etiological factors (p>0.05). Overall, clinical pregnancy and LBR reached up to 20% and 25% respectively. No adverse reactions were reported. Conclusions: PRP enhances EMT significantly during fresh and FET cycles in thin endometrium associated with TB, PCOS and DOR, thus improving the CPR and LBR in these low prognosis patients. Clinical Trial registration Number: CTRI/2018/12/016799