Autologous Platelet Rich Plasma (A-PRP) in Unexplained Infertility: A Revolution in Reproductive Medicine

Background: Any treatment for unknown infertility is empiric by default, and the broad range of treatment, including expectant management, superovulation, IUI, IVF and IVF–intracytoplasmic sperm injection, reflects the uncertainty with this diagnosis. There are limited data to support the efficacy of many of these treatments, and no uniform protocol exists in clinical practice. Autologous platelet rich plasma (A-PRP) can be a novel technique which has never been explored before much in this field. Objective: To compare autologous platelet rich plasma with expectant management in cases of unexplained infertility. Materials and methods: All cases (50) of primary unexplained infertility were treated with either A-PRP or by expectant management on the basis of their endometrial thickness (7 mm). All cases of thin endometrium (<7 mm) were subjected to A-PRP (25 cases). Whereas rest of the cases (25 in number) was monitored as per expectant management protocol for a maximum of three cycles after which they were switched over to being treated with PRP. The main outcomes measured were number of follicles, endometrial thickness, pregnancy rate and miscarriage rates. The statistical analysis was evaluated with IBM SPSS Statistics for Windows, Version 24.0, IBM Corp, and Chicago, IL. Results: Out of 46 patients, 25 patients (54.35%) got conceived with a single dose of intra-uterine autologous platelet rich plasma injection, which was found to be statistically highly significant. The correlation analysis with Spearman’s Rank correlation coefficient (rho ρ) was 0.891 which show highly positive correlation between intrauterine autologous platelet rich plasma injection and pregnancy rate and 0.247 which show weakly positive correlation between expectant management and pregnancy rate. Conclusion: Autologous platelet rich plasma (A-PRP) is a novel technique than can treat unexplained infertility with favorable outcomes.