The Effectiveness of Hysteroscopic Subendometrial Injection of Autologous PRP with our Special Guide in Women of Advanced Age with Diminishing Ovarian Reserve and Thin Endometrium on Endometrial Thickness and Reproductive Outcomes During Frozen Embryo Transfer Dirençli İnce Endometriyumu Olan Azalmış Over Rezervli İleri Yaştaki Kadınlarda, Özel Kılavuzumuz Eşliğinde Histeroskopik Subendometriyal Otolog PRP Uygulaması Sonrası Donmuş Embriyo Transferi Sikluslarında Endometriyum Kalınlığı ve Üreme Sonuçlarının Değerlendirilmesi

Uslu H., Özcan P., ERMİN E., Saridoğan E., Karaman Y.

Turkish Journal of Reproductive Medicine and Surgery, cilt.10, sa.2, ss.49-55, 2026 (Scopus, TRDizin)

Özet

Objective: The aim of this study was to evaluate the effectiveness of hysteroscopic subendometrial injection of autologous platelet-rich plasma (PRP) using our special guide on endometrial thickness (ET) and reproductive outcomes in women of advanced reproductive age with diminished ovarian reserve (DOR) and suboptimal ET prior to frozen embryo transfer (FET). Material and Methods: This retrospective study analyzed the outcomes of 15 women of advanced reproductive age with DOR whose embryo transfer cycles had previously been canceled due to suboptimal ET (<7 mm). Autologous fresh PRP was injected hysteroscopically into the subendometrial zone between cycle days 21 and 24 of the luteal phase of the cycle preceding FET. In the subsequent cycle, all patients underwent artificial endometrial preparation followed by FET. Age, serum anti-Müllerian hormone (AMH) levels, the number of previous hysteroscopies, American Fertility Society score, ET prior to intervention and after PRP injection and reproductive outcomes were recorded and analysed. Results: The mean age of the patients was 40.06±3.75 years, and the mean AMH level was 0.61±0.45 ng/mL. A significant difference was observed in ET. The mean preoperative ET was 6.18±0.54 mm, which increased to 7.21±0.53 mm after hysteroscopic subendometrial PRP injection (p<0.001), demonstrating a clear incremental improvement. Following artificial FET, of all women, 5 (33.3%, 5/15) achieved pregnancy. Among these pregnancies, 2 (13%, 2/15) resulted in live birth. Conclusion: Hysteroscopic subendometrial injection of autologous PRP using a specially designed guide may not apparently improve the live birth rate despite improvement in improving ET as a safe and potentially effective intervention in women of advanced age with DOR called as “a difficult to treat population” who previously exhibited suboptimal ET prior to FET.