Aim: This is a pilot prospective self-controlled trial study. It aimed to explore the efficacy of intrauterine infusion of autologous
platelet-rich plasma (PRP) in infertile ladies as an adjuvant to clomiphene citrate (CC) in ladies with previous CC failure
attributed to a thin endometrium (≤ 7 mm).
Materials and Methods: This study included thirty anovulatory PCOS women with CC failure for 3 cycles with a thin
endometrium (7 mm). All patients underwent ovarian stimulations for 2 cycles; control cycle (30 women received CC
alone and one got pregnant) and study cycle (29 women received CC plus an intrauterine infusion of PRP). Main endpoints
included the comparison of the endometrial thickness (ET) and endometrial vascularity pattern by power Doppler on the
day of hCG injection between both treatment cycles.
Results: There was a statistically significant increase in the endometrial thickness on the day of hCG injection with
CC plus PRP compared to CC alone (8.98 ±1.31 vs, 5.8 ±1.2; p < 0.0001). There was a significant improvement in the
endometrial blood flow with the use of PRP (p= 0.00004). The pregnancy rate is significantly higher in the PRP cycles
compared to control cycles (7 pregnancies (24.14%) vs. one pregnancy (3.3%) respectively; p = 0.0257).
Conclusion: Intrauterine infusion PRP seems to be a promising adjuvant to increase endometrial thickness and endometrial
blood flow with subsequent improvement in clinical pregnancy rate in ladies with CC failure due to thin endometrium.
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