PRP Application in IVF Method

What is PRP?

PRP stands for "Platelet Rich Plasma," which is a treatment procedure that uses the individual's own blood. It can be translated into Turkish as "trombosit bakımından zengin plazma." It involves the isolation and concentration of plasma from a person's blood. PRP can be used in a wide variety of conditions, from sports injuries to hair loss. It is thought to stimulate healing when injected.

Blood consists of four components: red blood cells, white blood cells, platelets, and plasma.

Platelets are the smallest type of blood cells and resemble small plates 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 the platelets that receive this signal arrive at the area. This structure transforms into an active form and creates clusters to block the area until the wound heals.

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

Some commonly applied PRP injections include:

• Hair Loss: Can be used to prevent hair loss and promote growth.
• Tendon Injuries: Tendons connect muscles to bones. Healing can take time when they are damaged. It can be applied in the treatment of chronic tendon problems.
• Acute Injuries: Can be used to accelerate the healing process in sudden injuries, especially in professional athletes.
• Calcification: PRP applied to the knee may help osteoarthritis patients.
• Dermatological Application: Used to enhance the skin's brightness and beauty.

What is PRP Application in the IVF Method?

In recent years, the increasing use of PRP in various fields has prompted scientists to consider its effectiveness in the IVF method. Several studies have been conducted to research this topic. In the IVF method, PRP application involves the injection of platelets obtained from the individual's own blood into the ovaries. This application aims to improve egg quality. Additionally, it also aims to enhance the thickness of the uterine lining and endometrial receptivity (the layer prepared for embryo implantation).

There are two types of IVF treatment. The classical IVF method involves fertilizing eggs obtained from the woman with sperm from the man in a laboratory environment and placing the fertilized embryo into the uterus. In this application, multiple eggs are retrieved from the woman to increase the likelihood of fertilization. However, women typically develop one egg per month. Therefore, in the IVF method, medications that stimulate the ovaries are generally used to target the production of multiple eggs.

Although the PRP application in the IVF method has not yet been officially approved by clinical institutions, there have been positive responses from patients who have tried it. Additionally, this treatment can be seen as promising, especially for patients who do not respond to other methods aimed at increasing ovarian reserve.

Who Can Receive PRP in the IVF Method?

The IVF method may be preferred when fertilization does not occur naturally, when the embryo fails to implant in the mother's uterus after fertilization, or when there is a genetic disease in either parent. However, not everyone undergoing IVF may receive PRP treatment.

PRP is used in the context of increasing the quantity and quality of eggs that will be used in the IVF procedure, increasing the thickness of the uterus (the area where the baby develops), and facilitating the baby's implantation. Therefore, there may be no need for PRP treatment in a patient seeking IVF to prevent a genetic disease from passing on to the baby. Additionally, although studies related to PRP are ongoing and promising responses are being received, the PRP method is not yet FDA-approved. Thus, it may not be among the initially recommended methods. However, PRP application can be considered for families that have tried various medical and pharmaceutical treatments and have undergone multiple IVF cycles without success. While there are different applications, it is mostly tested before donor eggs are taken from the woman.

How is PRP Applied in the IVF Method?

PRP can be preferred in various applications. For example, it may be used to accelerate wound healing or to reduce hair loss. While the method of obtaining PRP is similar across all applications, its effects can vary depending on the area where it is applied. The process of obtaining PRP involves the following steps:

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 the PRP will be used.
Next, the collected blood is placed in a centrifuge machine. This machine spins rapidly, causing the blood components to separate from one another. This process takes about 15 minutes.
Then, the plasma component, which contains a low amount of cellular components and a high amount of platelets, is collected and prepared for injection.
PRP application can be performed in two different ways, depending on its purpose.

PRP for Egg Quantity and Quality

The goal of this procedure is to improve the quality and increase the number of eggs. This method can be applied using two different procedures.

• Intraovarian: This procedure involves the direct injection of 1 to 3 ml of PRP into the ovaries. This method is performed by a doctor while the individual is under anesthesia. During the procedure, a needle containing PRP passes through the vaginal wall and is applied directly to the ovaries. The procedure is guided by ultrasound. This procedure is performed about two to three months before the egg retrieval for IVF.
• High-Volume Intrauterine PRP: In this procedure, PRP is not applied directly to the ovaries. Instead, a large volume (8-10 ml) of PRP is administered into the uterus, which then flows to the fallopian tubes and subsequently to the ovaries. After the procedure, the catheter is removed, and the patient waits for 10 minutes to ensure that the PRP has reached the target area.

PRP for Uterine Growth and Endometrial Receptivity (PRP Uterine Wash)

The aim of this procedure is to increase the endometrial layer on the inner surface of the uterus, facilitating embryo implantation. This procedure is performed approximately 48 hours before the embryo is transferred to the uterus. About 3-5 ml of PRP is used during the procedure, which is administered into the uterus using a catheter. This procedure is carried out by an endocrinologist specializing in this area. If the procedure is intended to enhance the uterine lining, PRP is administered directly after the initial examination. Follow-up assessments are conducted, and if the results are insufficient, the procedure may be repeated, allowing for a waiting period of 72 hours before doing so.

When is PRP Application Performed in the IVF Method?

There are multiple methods for PRP application in IVF. The application methods vary based on the purpose for which PRP is used, which also affects the timing of the application. For example, a patient receiving PRP to improve egg quality will undergo the procedure two or three months prior to donor egg retrieval, whereas a patient receiving PRP to support the development of the endometrial lining will have it applied 48 hours before embryo transfer.

How is Follow-Up Conducted After PRP Application?

PRP application is a relatively new practice in infertility treatment, and its effects have not yet been scientifically validated. However, its success in patients struggling to achieve a successful pregnancy has led to it being seen as a promising method for the future. Since PRP generally promotes growth, there is no need for a lengthy rest period after the procedure. The follow-up after PRP application is similar to that of the IVF method. Your doctor or a healthcare professional from their team will provide you with information regarding what to pay attention to and the frequency of appointments.