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Subendometrial platelet-rich plasma injection for refractory thin endometrium: a prospective pilot study
Hui Zhang1, Huiyan Wang2, Jinfeng Yu3
1Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
Scientific Reports
|February 16, 2026
Summary
Subendometrial platelet-rich plasma (PRP) injections significantly increased endometrial thickness (EMT) in women with refractory thin endometrium. This treatment led to a 44.4% clinical pregnancy rate, offering a promising alternative for infertility treatment.
Area of Science:
- Reproductive Medicine
- Regenerative Medicine
- Gynecology
Background:
- Refractory thin endometrium, defined as endometrial thickness (EMT) < 7 mm, poses a significant challenge in assisted reproductive technology (ART).
- Conventional treatments, including high-dose oestrogen and surgical adhesiolysis, often yield suboptimal results for patients with a history of multiple failed treatments.
- Identifying novel therapeutic strategies to improve endometrial receptivity is crucial for enhancing pregnancy outcomes.
Purpose of the Study:
- To evaluate the efficacy of subendometrial autologous platelet-rich plasma (PRP) injections in improving EMT and pregnancy outcomes.
- To assess the impact of PRP on subendometrial blood flow, intrauterine adhesion (IUA) status, and platelet concentration.
- To determine the safety and tolerability of subendometrial PRP injections in women with refractory thin endometrium.
Main Methods:
- A prospective, single-arm, self-controlled trial involving 21 women with refractory thin endometrium (EMT < 7 mm).
- Subendometrial autologous PRP injections were administered, and EMT, reproductive outcomes, subendometrial blood flow, IUA status, and platelet count (PLT) were assessed pre- and post-treatment.
- Paired t-tests and Fisher's exact tests were used for data analysis.
Main Results:
- Subendometrial PRP injections significantly increased mean EMT from 6.55 mm to 7.50 mm (p < 0.001).
- 66.7% of patients achieved an EMT ≥ 7 mm post-treatment, with a clinical pregnancy rate of 44.4% in frozen-thawed embryo transfer cycles.
- A significant decrease in cycle cancellation rates was observed (2.62 vs. 0.71, p = 0.016), and the procedure was safe with no adverse events.
Conclusions:
- Subendometrial autologous PRP injections are effective in improving endometrial thickness and achieving a notable clinical pregnancy rate in women with refractory thin endometrium.
- PRP treatment represents a promising alternative for patients unresponsive to conventional therapies, potentially improving fertility outcomes in ART.
- Further research with larger sample sizes is warranted to confirm these preliminary findings and optimize treatment protocols.
