PRP – Platelet Rich Plasma therapy in infertility
Platelets are blood cells that have a unique ability to divide rapidly. They are very rich in cytokines and many other growth-promoting factors. Activation and enrichment of platelets make them even more capable functionally. PRP is used as a rejuvenation tool in many areas of medicine. PRP helps in the growth of the tissues.
Applications of PRP fertility treatment
Ovarian Rejuvenation
Injection of concentrated, activated, enriched PRP can enhance the egg-producing capacity of the ovaries. BFI has achieved many natural pregnancies also in these very poor pregnancy chance couples. Read more
Endometrial rejuvenation
Infections, surgeries or miscarriages can scar and cause severe damage to the endometrium – the functional layer of the uterus. This causes the walls of the uterus to stick together, forming adhesions.
Surgical correction by cutting the adhesions is possible with hysteroscopy. However, the new functioning endometrial layer should grow and cover the cut areas for good function.
Endometrial PRP can be done by a simple catheter (small soft tube). Here the PRP concentrate is injected into the uterus. The concentrate stays on the uterine lining and gradually absorbed in the functional layer. Disadvantage of this approach is that some proportion is not absorbed. Second option is hysteroscopy guided PRP
PRP injection can help and promote normal endometrial growth and help achieve pregnancy.
Who should consider PRP fertility treatment?
- Women with diminished ovarian reserve: PRP therapy may help stimulate ovarian function and improve egg quality in women with low ovarian reserve.
- Recurrent implantation failures : PRP therapy may be used as an adjunct to procedures such as in vitro fertilization (IVF) to improve the success rates of embryo implantation.
In patients of recurrent implantation failure endometrial PRP may improve immune tolerance to embryos. Immune tolerance is a unique mechanism of the uterine lining which allows acceptance of embryos which are partly foreign genetic structure (because of father’s genes). Low immune tolerance is a potential cause of failed implantation of embryos. By enhancing immune tolerance PRP potentially improves implantation possibilities. Evidence is limited in this aspect of PRP treatment. - Men with male factor infertility: PRP treatment may be beneficial for men with conditions such as low sperm count or poor sperm motility, as it can potentially improve sperm quality and function. This area of PRP treatment is still under development.
PROCEDURE OF PRP PREPARATION
- Patient Evaluation and Consultation: The process begins with a thorough evaluation of the patient’s medical history, current health status, and specific concerns related to their condition. This evaluation helps the healthcare provider determine whether PRP therapy is an appropriate treatment option for the patient’s needs.
- Blood Collection: Once the decision is made to proceed with PRP therapy, the patient undergoes a blood collection procedure. This typically involves drawing a small amount of blood from a vein in the arm, similar to a routine blood test.
- Blood Processing: The collected blood is then processed in a specialized device called a centrifuge. The centrifuge spins the blood at high speeds, separating it into its individual components based on density. This process typically takes about 10-15 minutes.
- Separation of Platelet-Rich Plasma: As the blood spins in the centrifuge, the heavier components, such as red blood cells and white blood cells, are separated from the lighter plasma. The plasma layer, which contains a higher concentration of platelets, is carefully collected using sterile techniques.
- Platelet Activation (Optional): In some cases, the collected PRP may be further processed to activate the platelets before application. Activation can be achieved using various methods, such as the addition of calcium chloride or thrombin, which triggers the release of growth factors from the platelets.
- Preparation for Application: Once the PRP is obtained and, if necessary, activated, it is prepared for application to the target area. The specific preparation method may vary depending on the intended use of PRP therapy and the preferences of the healthcare provider.
- Application of PRP: The prepared PRP is then administered to the patient through various methods, including injection in ovaries, injection in uterine lining by hysteroscopy, insertion in uterus or other methods. The delivery method depends on the treatment goals and the condition being addressed.
- Post-Treatment Care: After PRP therapy, patients may receive instructions for post-treatment care to optimize results, minimize potential side effects.
- Monitoring and Follow-Up: Patients are typically monitored following PRP therapy to assess their response to treatment and make any necessary adjustments to their care plan. Follow-up appointments may be scheduled to track progress and ensure optimal outcomes.
How is PRP used for IVF and other fertility treatments?
PRP therapy is increasingly being utilized in conjunction with assisted reproductive technologies such as IVF (In Vitro Fertilization) and IUI (Intrauterine Insemination) to enhance fertility outcomes. In IVF, PRP can be injected into the uterus to improve endometrial thickness and the receptivity of the endometrium. PRP can be injected in the ovaries to increase egg number and improve ovarian micro-environment.
What is the cost of PRP for IVF?
The cost of PRP therapy for IVF can vary depending on factors such as the place of injection, clinic, the specific treatment protocol, and the need for any repeat doses.
What can one expect during the Intraovarian PRP Therapy procedure?
During the intraovarian PRP therapy procedure:
- The patient may receive anesthesia to minimize discomfort.
- A thin needle is used to inject PRP directly into the ovaries under ultrasound guidance.
- The entire procedure typically takes 15 minutes and can be performed on a daycare basis.
ADVANTAGES OF PRP
It is prepared from the patients to own blood, so no outside drug or material is injected into the body. It is a very simple & relatively inexpensive process. The effect can last for a long time, not only for one treatment cycle.
DISADVANTAGES AND LIMITATIONS OF PRP
PRP is still a new procedure. Even after PRP treatment, no improvement may occur.
Side Effects of PRP Therapy
PRP therapy is generally considered safe, as it utilizes the patient’s own blood, minimizing the risk of allergic reactions or rejection. However, side effects may include:
- Pain or Discomfort
- Swelling
- Bruising
- Infection
- Allergic Reaction
What are the success rates of PRP therapy in improving fertility outcomes?
The success rates of PRP therapy in improving fertility outcomes can vary depending on factors such as the patient’s age, underlying fertility issues, and treatment protocol. While some studies have reported promising results, further research is needed to establish the long-term efficacy of PRP therapy in infertility treatment.
FAQs
Yes, PRP therapy is generally considered safe when administered by qualified healthcare professionals. Since it utilizes the patient’s own blood, the risk of allergic reactions is minimal. However, as with any medical procedure, there may be potential risks and complications, which should be discussed with your physician beforehand.
PRP therapy offers a complementary approach to traditional fertility treatments by addressing underlying factors such as poor ovarian reserve or thin endometrial lining. It can be used in conjunction with IVF or IUI to enhance the chances of conception.
PRP works by two types of effects. The growth factor in PRP starts working immediately from time of injection. This effect tends to wane of in around 6-12 months. The other poorly understood mechanism is stem cell like action which takes 3-6 months to start showing results. Depending on the treatment goal, other fertility treatments are started. In patients with suboptimal function of ovaries or endometrium immediate fertility treatment may be suggested. When there is extremely low to minimal function of ovaries, a gap of 3 months may be suggested before IVF or other fertility treatments.
While there are generally no strict age restrictions for PRP therapy, patients should undergo a thorough evaluation to assess their suitability for treatment. Individuals with certain health conditions or contraindications may not be suitable candidates for PRP therapy.
The number of PRP therapy sessions required to see results in fertility may vary depending on factors such as the patient’s individual response to treatment and the severity of their fertility issues. A personalized treatment plan will be developed based on the patient’s needs and goals.
Patients can typically resume normal activities immediately after PRP therapy, although some mild discomfort at the injection site may occur. It is advisable to avoid strenuous activities or heavy lifting for a day or two following treatment.
Patients may be advised to follow certain lifestyle recommendations before and after PRP therapy to optimize treatment outcomes. These may include maintaining a healthy diet, avoiding smoking and excessive alcohol consumption, and managing stress levels. It is important to follow any specific instructions provided by the treating physician.
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