PRP Application in In Vitro Fertilization (IVF) Method

What is PRP?

The PRP process, which is shortened from the initials of “Platelet Rich Plasma” in English, is a type of treatment procedure performed using the person’s own blood. It can be translated into Turkish as platelet-rich plasma. It is the obtaining of plasma from the blood of the individual by isolated and concentrated methods. It can be used in a wide variety of situations, from sports injuries to hair loss. It is thought to trigger healing if injected.

Blood; It includes 4 components: red blood cell, white blood cell, platelet and plasma.

Platelets are the smallest of blood cells. It resembles small plaques in shape. These cells are responsible for blood clotting, thus controlling bleeding. Any wound in the body sends a signal to the blood vessels, and platelets that receive this signal reach the area. This structure, which turns into an active form, contacts the vein and forms clusters to block it until the wound heals.

Researchers produce PRP by separating blood plasma and then concentrating it. The main goal in this process is to trigger the body’s formation of healthy and new cells and encourage healing by injecting PRP into damaged tissues. Although the PRP process is applied by famous athletes, it has not yet been approved by the FDA (Food and Drug Administration).

Some commonly administered PRP injections include:

• Hair loss: It can be applied to prevent hair loss and stimulate growth.
• Tendon injuries: Tendons connect muscles to bones. In cases where it is damaged, it may take time to heal. It can be applied in the treatment of chronic tendon problems.
• Acute injuries: It can be used to accelerate the healing process, especially in sudden injuries that occur in professional athletes.
• Osteoarthritis: PRP procedure applied to the knee may help patients with osteoarthritis.
• Dermatological application: It is applied to increase the brightness and beauty of the skin.

What is PRP Application in In Vitro Fertilization (IVF) Method?

The use of PRP in various fields in recent years has led scientists to consider its effectiveness in in vitro fertilization. Various studies have been conducted to investigate the subject. In the in vitro fertilization method, PRP application is performed by injecting platelets obtained from the person’s own blood into the ovaries. This application aims to improve egg quality. In addition, it is aimed to improve the thickness of the uterine lining and endometrial receptivity (the layer that is ready for the embryo to attach).

In vitro fertilization treatment is of two types. The IVF method, also known as the classical method, is the process of fertilizing the egg taken from the woman and the sperm cells taken from the man in a laboratory environment and placing them in the uterus. In this procedure, more than one egg is taken from the woman to increase the chance of fertilization. However, women develop one egg per month. For this reason, the IVF method generally aims to produce more than one egg by using drugs that stimulate the ovaries.

Although PRP application in in vitro fertilization method has not yet been clinically approved by official institutions, positive feedback is found on patients who have tried it. In addition, this treatment can be seen as promising, especially for patients who do not respond to other methods applied to increase ovarian reserve.

To whom can PRP be applied in the In Vitro Fertilization Method?

In vitro fertilization may be preferred when fertilization does not occur naturally, when the embryo cannot attach to the mother’s uterus after fertilization and there are repeated miscarriages, or when either of the parents has a genetic disease. However, PRP may not be applied to everyone who undergoes in vitro fertilization.

PRP process is used for purposes such as increasing the quantity and quality of eggs to be used in in vitro fertilization application, increasing the thickness of the uterus, which is the area where the baby develops, and holding the baby. Therefore, there is no need to apply PRP to a patient who applies for in vitro fertilization to prevent the genetic disease from being passed on to her baby. In addition, although studies on PRP continue and promising results are obtained, the PRP method is not yet an FDA-approved method. Therefore, it may not be one of the first recommended methods. However, PRP application can be tried in families who have tried various medical and drug treatments and have not received a response despite having undergone more than one IVF cycle. Although it has different applications, it is mostly tried before donor eggs are taken from the woman.

How is PRP Applied in In Vitro Fertilization Method?

PRP process can be preferred in many different applications. For example, it is sometimes used to accelerate wound healing, and sometimes it can be used to reduce hair loss. Although the method of obtaining PRP is similar in all applications, its effects may differ depending on the region where it is applied. In the process of obtaining PRP, the following is carried out:

• First, a healthcare professional takes a sample of blood from your body. The amount of blood taken may vary depending on the procedure for which PRP will be used.
• The collected blood is then placed in a centrifuge machine. This machine rotates rapidly, causing the blood components to separate from each other. This process takes approximately 15 minutes on average.
• Then, the plasma portion containing less cellular components and more platelets is taken and prepared for injection.

PRP application can be applied in 2 different ways depending on its purpose.

PRP for Egg Quantity and Quality

The purpose of this process is to improve the quality of the egg and increase its number. This method can be applied with 2 different procedures.

• Intraovarian: This procedure involves injecting 1 to 3 ml of PRP directly into the ovaries. This method is performed by the doctor while the person is under anesthesia. During the application, a needle containing PRP passes through the vaginal wall and is applied directly to the ovaries. During the procedure, ultrasound imaging is provided. This process is done about two or three months before the egg application for in vitro fertilization.
• High Volume Intrauterine PRP: In this procedure, PRP is not applied directly to the ovaries. PRP given in large amounts (8-10 ml) into the uterus first flows into the fallopian tubes and then into the ovaries. After the procedure, wait 10 minutes before removing the catheter. This ensures that it reaches the area.

PRP for Intrauterine Growth and Endometrial Receptivity (PRP Intrauterine Washing)

The purpose of this procedure is to increase the endometrium layer on the inner surface of the uterus so that the embryo can attach to the uterus. This process is performed approximately 48 hours before the embryo is transferred into the uterus. Approximately 3-5 ml of PRP is used during the procedure. This fluid is injected into the uterus with the help of a catheter. The procedure is performed by an endocrinologist working in this field. If the procedure is performed to improve the uterine lining, PRP is performed directly after the first check. Afterwards, it is monitored and the process is repeated in cases where it is deemed inadequate. Wait 72 hours before the process is repeated.

When is PRP Application Done in In Vitro Fertilization Method?

There is more than one method of PRP application in in vitro fertilization. Depending on the purpose for which PRP is applied, the application methods also vary. This also affects the time of application of PRP. For example, a patient who has PRP to improve egg quality is treated two or three months before receiving a donor, while PRP is applied to a patient 48 hours before the embryo is transferred to support the development of the endometrium layer.

How to Follow Up After PRP Application?

PRP application is a practice that has just begun to be used in the treatment of infertility and its effects have not yet been scientifically accepted. However, its success in patients who have difficulty in having a successful pregnancy makes it seen as a promising method for the future. Since PRP application generally promotes growth, you do not need a long rest period after the procedure. Follow-up after PRP application is similar to the in vitro fertilization method. Your doctor or a healthcare professional on his team will inform you about what you need to pay attention to or the frequency of appointments.