Platelet-rich plasma in reproductive medicine: Bridging endometrial repair and maternal-fetal immune regulation

Platelet-Rich Plasma (PRP) has emerged as a promising biological agent in reproductive medicine, with validated efficacy in managing endometrial disorders and improving pregnancy outcomes in recurrent implantation failure (RIF). Specifically, PRP modulates uterine Natural Killer (uNK) cell cytotoxicity, drives macrophage polarization toward the anti-inflammatory M2 phenotype through the AMPK signaling pathway, and fine-tunes T cell subset balance and function. These coordinated immunomodulatory actions, coupled with its endometrial repair capacity, collectively foster a maternal-fetal immune tolerance state critical for successful embryo implantation and pregnancy maintenance, thus providing a novel integrated strategy for reproductive disorders. However, the clinical translation of PRP is currently hindered by the lack of standardized preparation protocols and an incomplete elucidation of its precise molecular mechanisms underlying the crosstalk between endometrial repair and maternal-fetal immune regulation. We conclude that future research should focus on establishing disease-specific standardized PRP workflows and leveraging multi-omics technologies to decipher the core regulatory pathways of this bridging effect. This will pave the way for developing targeted therapies and optimizing the clinical application of PRP in reproductive medicine.