Uterine PRP Infusion: What the Evidence Actually Shows

Platelet-rich plasma (PRP) infusion into the uterus has emerged as a treatment offered for two specific problems: thin endometrial lining that doesn't develop adequately for embryo transfer, and recurrent implantation failure despite good-quality embryos.

The theory: PRP contains concentrated growth factors that may stimulate endometrial cell proliferation, angiogenesis, and receptivity. Injected into the uterine cavity in the days before transfer, it might improve lining thickness or receptivity.

How It's Done

Autologous PRP is prepared from the patient's own blood:

1. Blood drawn (typically 30–60 mL)
2. Centrifuged to separate platelets from other blood components
3. Platelet fraction concentrated to 4–7× baseline
4. Infused into the uterine cavity via thin catheter, typically 24–72 hours before scheduled embryo transfer

The procedure takes about an hour total. Discomfort is minimal.

Thin Endometrium: The Study Landscape

Multiple small trials have looked at uterine PRP for patients with persistently thin endometrium (typically defined as <7 mm despite estrogen priming). Rough pattern:

• Small case series consistently report increased endometrial thickness after PRP infusion (typical increases of 1–2 mm)
• Small randomized trials have shown improved clinical pregnancy rates compared to no PRP
• Effect sizes are large in some studies, modest in others
• Total number of patients studied remains small — hundreds, not thousands

The overall evidence pattern is: promising but preliminary. For patients with genuinely refractory thin endometrium who've exhausted standard options, PRP is a reasonable trial. For patients with adequate endometrial development on standard protocols, the evidence does not support routine use.

Recurrent Implantation Failure: Less Clear

Some clinics also offer uterine PRP for recurrent implantation failure (RIF) with normal endometrial thickness. The evidence here is thinner — smaller studies, less consistent findings. Some trials show benefit; others show no effect versus control.

The reasonable position: PRP for RIF with normal lining is investigational. Not clearly beneficial, not clearly harmful. If a comprehensive RIF workup has failed to identify a cause and standard treatments have failed, adding PRP is a defensible experimental choice. Not a first-line recommendation.

Safety Profile

PRP infusion appears very safe:

• Autologous (patient's own blood) so no immune or infection risk from donor material
• Preparation is straightforward, standardized in most fertility labs
• Infusion complications are rare — occasional cramping or spotting
• No known negative effects on subsequent pregnancy

The primary risk is cost without benefit rather than direct harm.

Cost Framing

PRP is not typically covered by insurance in the US. In Colombia, it's generally offered as an add-on to a treatment cycle.

Regulatory Position

PRP is FDA-regulated in the US as an autologous biological — clinics can offer it but claims about efficacy are subject to marketing rules. INVIMA (Colombia) treats it similarly. Neither agency has approved PRP as a treatment for infertility or thin endometrium specifically.

What to Ask Your Clinic

1. "For my situation, what does the evidence support?"
2. "What's the expected effect on my specific outcome?"
3. "Have less invasive options been tried?"
4. "What's the cost?"
5. "How does your program prepare and administer the PRP?"

The Realistic Position

Uterine PRP is not snake oil. It has plausible biology, promising early data, and low risk. It's also not a proven treatment with strong outcome data. For patients with refractory thin endometrium who've exhausted standard options, it's a reasonable experimental choice. For patients with normal lining and good embryos, the marginal benefit is unclear.

Any clinic marketing PRP as a routine premium add-on for average IVF cycles is overstating the evidence.