Efficacy of Intrauterine Infusion of Autologous Platelet-Rich Plasma for Women with Repeated Embryo Implantation Failure: A Systematic Review and Meta‐Analysis of Randomised Controlled Trials

Objectives: Repeated embryo implantation failure (RIF) can occur during any of the three stages of implantation. Various interventions have been employed to increase the implantation rate and subsequently the chance of live birth rate. Platelet-rich plasma (PRP) is one of the most promising interventions to increase implantation, pregnancy, and live birth rates. Methods: We have searched PubMed, Scopus, Web of Science, and Cochrane, in addition to other relevant resources. Meta-analysis using a random-effects model was performed to calculate the pooled estimates. Results: Eight randomized clinical trials, enrolling 1038 women with more than 3 implantation failure attempts, have been included. We found a significant increase regarding all our prespecified primary outcomes. The probability of chemical pregnancy (risk ratio (RR): 1.96, 95 % confidence intervals (CI): 1.61, 2.39; P<0.001), clinical pregnancy (RR: 4.35, 95 % CI: 1.92, 2.88; P<0.001), and Live birth rate (RR: 4.03, 95 % CI: 1.29, 12.63; P= 0.02) was significantly higher in women who received PRP compared with control. Implantation rate (RR: 1.98, 95 % CI: 1.34, 2.75; P<0.001), miscarriage rate (RR: 0.44, 95% CI: 0.23, 0.83, P= 0.01), and multiple pregnancy rate (RR: 2.56, 95% CI: 1.02, 6.42, P= 0.04) were also found to be significantly increased in PRP group. Conclusion: We provide strong evidence of how intrauterine infusion of platelet-rich plasma can increase implantation and pregnancy outcomes in RIF patients, which should direct clinicians to consider this intervention as a very effective tool in assisted reproductive techniques.