Role of Intrauterine Platelet Rich Plasma in Inducing High Pregnancy Rates in Women with Unexplained Infertility Undergoing Intra Uterine Insemination/ In Vitro Fertilisation with Ovarian Stimulation

Background: Despite advances in assisted reproductive technologies (ART), implantation and pregnancy rates remain suboptimal in women with unexplained infertility, largely due to impaired endometrial receptivity. Intrauterine platelet-rich plasma (PRP), rich in growth factors, has emerged as a potential adjunct therapy to enhance endometrial thickness and improve implantation outcomes in patients undergoing intrauterine insemination (IUI) or in vitro fertilisation (IVF). Material and Methods: This non-randomised controlled trial was conducted at Teerthanker Mahaveer Medical College and Research Centre, Moradabad, over a period of 18 months. A total of 66 women with unexplained infertility undergoing their first cycle of IUI or IVF with ovarian stimulation were included. The intervention group received intrauterine infusion of autologous PRP, while the control group underwent standard IUI/IVF treatment without PRP. Endometrial thickness was assessed before and 48–72 hours after PRP administration using transvaginal sonography. Pregnancy outcomes were evaluated using urine pregnancy test, serum beta-hCG levels, and detection of fetal heart sounds. Statistical analysis was performed using SPSS version 24, with p ≤ 0.05 considered statistically significant. Results: The mean endometrial thickness increased significantly from 1.18 ± 0.28 mm before PRP to 4.03 ± 1.14 mm after PRP administration (p < 0.001). Positive urine pregnancy test results were observed in 84.8% of patients in the PRP group compared to 27.3% in the non-PRP group (p < 0.001). Mean serum beta-hCG levels were significantly higher in the PRP group (33.04 ± 5.01) than in the control group (11.70 ± 2.19; p = 0.001). The presence of fetal heart sounds was also significantly higher in the PRP group (84.8%) compared to controls (27.3%). Conclusion: Intrauterine platelet-rich plasma significantly improves endometrial thickness and pregnancy outcomes in women with unexplained infertility undergoing IUI or IVF with ovarian stimulation. PRP appears to be a safe and effective adjunctive therapy for enhancing endometrial receptivity and increasing clinical pregnancy rates. Further large-scale randomised controlled trials are recommended to standardise PRP protocols and confirm long-term efficacy.

Keywords: Unexplained Infertility, Endometrial thickness, PRP, IUI, IVF, transvaginal sonography.