Endometrial thickness after platelet-rich plasma infusion linked to live birth in thin endometrium study

Women with a persistently thin endometrium who received an intrauterine infusion of platelet-rich plasma before frozen embryo transfer showed a marked increase in endometrial thickness, and the thickness achieved after treatment was significantly associated with whether a pregnancy ended in a live birth, according to a retrospective single-arm cohort study published in BMC Pregnancy and Childbirth.

The study analyzed 139 frozen embryo transfer cycles in patients with thin endometrium. All participants received an intrauterine infusion of platelet-rich plasma at a platelet concentration of approximately 1000 to 1200 × 10⁹ per liter. Because the design was self-controlled, the researchers compared endometrial thickness in the treatment cycle with measurements from the patient’s own previously canceled cycle.

Endometrial thickness improved significantly after the infusion, rising from a mean of 5.6 ± 1.0 mm in the previous canceled cycle to 7.0 ± 1.0 mm in the treatment cycle, a difference the authors reported as statistically significant with P < 0.01.

Reproductive outcomes in the treated cycles were reported as follows: the biochemical pregnancy rate was 52.5 percent (73 of 139 cycles), the clinical pregnancy rate was 45.3 percent (63 of 139), and the live birth rate was 34.5 percent (48 of 139).

To identify which factors influenced outcomes, the researchers performed multivariate regression analysis on the frozen embryo transfer results. This analysis revealed a strong link between endometrial thickness after platelet-rich plasma infusion and live birth, with a reported P value of 0.02.

In contrast, the number of platelet-rich plasma infusions a patient received showed no significant association with the live birth rate, with a reported P value of 0.946. According to the authors, infusion frequency was not related to live-birth outcomes in this cohort.

The study’s conclusions state that platelet-rich plasma infusion was associated with increased endometrial thickness and favorable pregnancy outcomes in patients with thin endometrium, and that endometrial thickness after the infusion was significantly associated with live birth. The authors emphasize, however, that these findings come from a retrospective design without a control group, which limits the strength of the conclusions.

A thin endometrium is described in the study background as closely associated with adverse reproductive outcomes during the implantation window. Within regenerative medicine, platelet-rich plasma has been considered a promising therapeutic option, but the authors note that evidence supporting its efficacy in patients with thin endometrium remains limited.

The authors call for well-designed randomized controlled trials to validate the efficacy of platelet-rich plasma for this indication. Until such trials are completed, the current results should be interpreted as observational associations from a single-arm cohort rather than proof of treatment effect, since the absence of a control group means the reported improvements and pregnancy outcomes cannot be attributed to the infusion with confidence.

Subject of Research: Intrauterine platelet-rich plasma infusion, endometrial thickness and live birth in frozen embryo transfer cycles with thin endometrium

Article Title: Endometrial thickness after platelet-rich plasma infusion is associated with live birth in women with thin endometrium undergoing frozen embryo transfer: a single-arm retrospective cohort study

Article References: Li, J., Jia, C., Xu, J., Wang, Z., Zhao, Y., & Zhang, L. (2026). Endometrial thickness after platelet-rich plasma infusion is associated with live birth in women with thin endometrium undergoing frozen embryo transfer: a single-arm retrospective cohort study. BMC Pregnancy and Childbirth. https://doi.org/10.1186/s12884-026-10164-7

Image Credits: AI Generated

DOI: 10.1186/s12884-026-10164-7

Keywords: platelet-rich plasma, thin endometrium, endometrial thickness, frozen embryo transfer, live birth, clinical pregnancy rate, infertility, retrospective cohort study, regenerative medicine, BMC Pregnancy and Childbirth, Endometrial, thickness