Hysteroscopic platelet-rich plasma and medically assisted reproduction outcomes: a systematic review and SWOT analysis.

TL;DR

Hysteroscopic platelet-rich plasma (PRP) administration for reproductive outcomes has limited evidence from only 3 small studies with heterogeneous protocols and mixed results. The quality and standardization of evidence are insufficient to support routine clinical use.

Key findings

• Only 3 studies met inclusion criteria; one case-control study showed improved implantation and live birth rates with hysteroscopic intraendometrial PRP injection, while another observational study found no benefit
• PRP administration protocols varied considerably across studies in timing (cycle days 6-8 vs 11-13), technique, volume, and delivery method, limiting comparability
• One randomized controlled trial in intrauterine insemination patients reported improved clinical pregnancy rate following hysteroscopic subendometrial PRP instillation
• Study populations were restricted to women with refractory thin endometrium and/or recurrent implantation failure, reducing generalizability

Why this matters at the bedside

Limited. Hysteroscopic PRP administration remains investigational for medically assisted reproduction; current evidence is too sparse and heterogeneous to guide clinical decision-making, and standardized protocols are lacking.