Can an injection of your own platelets help you get pregnant?

Alex Neckles and her husband had been trying to get pregnant for more than two years and had already been to four reproductive endocrinologists when they went to see Fady Sharara, M.D., at the Virginia Center for Reproductive Medicine in late 2021.

Dr. Sharara suggested she try a relatively new technique called platelet-rich plasma (PRP), using injections of her own concentrated platelets to try to boost her egg quality and quantity before in vitro fertilization (IVF).

"We pretty much felt like it was our last resort," recalls Neckles, who was 36 at the time. "We were willing to try anything."

PRP for fertility is still an experimental treatment and there’s a lot that medical experts are trying to learn about it. But if you’re navigating infertility (around 1 in 5 women in the United States have trouble getting pregnant after one year of trying), you may have heard about PRP through doctors or friends. Here’s what experts want you to know. 

What is a PRP injection? 

The general PRP technique involves injecting concentrated blood cells called platelets into areas of your body to accelerate healing. It has been used in medical settings for nearly 40 years after some injuries or surgery, for arthritis relief, to treat hair loss, or to rejuvenate the look of aging skin.

How is PRP used for infertility? 

For infertility specifically, PRP is in its experimental  stages with clinical trials happening across the country. So how might it help improve your odds of a successful pregnancy? Platelets are packed with growth factors, proteins, and other substances that promote the growth of new cells and stimulate healing. 

“The thought is that by using PRP in the ovaries or in the endometrium, some of these growth factors can hopefully improve the environment where you're injecting them," says Dr. Sharara, who is a board-certified reproductive endocrinologist/infertility specialist.

Clinical research is showing positive early results when used alongside fertility treatments. PRP injections are expected to help thicken the uterine lining for a successful IVF implantation. PRP is also being researched in women with poor ovarian response, which is what Neckles experienced. The hope is that doing PRP will increase the number of mature eggs per cycle and your anti-mullerian hormone (AMH) level, says Dr. Sharara. However, there is still a lack of clinical data on this experimental treatment. 

What can I expect during PRP for infertility? 

If you are part of a clinical trial or your medical team is one that does already offer PRP for fertility, it would be done as an outpatient procedure, meaning you'll go home on the same day. To start the process, your fertility specialist will take some blood.

Your blood is then separated into red blood cells, platelets, and plasma and then processed to boost the growth factors and activate the platelets, says Dr. Sharara.

Once the sample is ready, it can be applied in two ways, depending on your doctor’s goal. If your uterine lining needs to thicken, your doctor would inject the plasma solution into this lining using a catheter. If the hope is to improve egg quality, your doctor will inject PRP into your ovaries with a needle (guided by ultrasound). 

You shouldn't feel anything during the catheter procedure. If you’re undergoing the needle injection, you’d get anesthesia to prevent you from feeling pain and to keep you still.

After either procedure, you'd have to wait for at least a month before you start an IVF cycle, says Dr. Sharara. That's because it takes time for the platelets to release their growth factors and have any effect. Those effects then last for about three months. If it's been more than six months since you had the procedure, your doctor can repeat it prior to a transfer.  

Does research show that PRP can help with infertility treatments?

"Anecdotally, yes," says Sasha Hakman, M.D., a double board-certified ob-gyn and reproductive endocrinologist with HRC Fertility in Los Angeles and member of the BabyCenter Medical Advisory Board. "There are some studies that have shown that it improves pregnancy rates."

One study of 38 women with low ovarian reserve produced 10 pregnancies and six healthy babies. In another study that included 83 women with a thin endometrium, the pregnancy rate was more than 32 percent in the PRP group compared to 14 percent in the group that didn't get this treatment. 

Those numbers sound good, but many of the studies on PRP have been small and poorly designed. Some only looked at pregnancy rates, not actual births. And none have proven that it was PRP – and not some other factor – that caused the pregnancies.

"It's always possible that it worked by chance and that it wasn't really the PRP that led to success," says Dr. Hakman. "That’s why in the medical field we really stress the importance of high-quality randomized clinical trials, so we know this was not due to chance alone, but to the therapy."

It’s also hard to say how PRP compares to other treatments because no other options are similarly injected into the ovaries (except for stem cell treatments that are currently being studied), says Dr. Sharara. Other fertility treatments are medications that promote ovulation.

Dr. Sharara agrees that we need more clinical trials to answer important questions about PRP. "Who does it work for and who doesn't it work for?" he asks. "This is what we're ultimately trying to find out."

How much does PRP cost? 

PRP is still considered experimental so health insurance, even fertility insurance, won’t cover the costs, according to Dr. Hakman. In clinics that do offer PRP, the price when used for infertility varies depending on the state and the clinic you choose, but you can expect to pay between $2,000 and $4,000 for the procedure, says Dr. Sharara.

Is PRP safe? 

PRP is safe. In fact, there haven't been any real side effects reported in studies. Because PRP uses your own blood, there's a low chance your body will reject it or have an adverse reaction to it.

There are a few theoretical risks, though. For example, during intrauterine PRP, the catheter could cause an infection in the uterus or pelvis. Or it might make a hole called a perforation in the uterus if it's put in too forcefully. However, "the chances of that happening are very miniscule," says Dr. Hakman. With most medical procedures, there is always a small risk of infection, but the risk here is no more than usual.

With ovarian PRP, there's a very small risk of infection as well, and a risk of bleeding or damage to nearby organs from the needle, she adds. "Luckily, the risk of these things happening is less than one percent." 

Should I try PRP for infertility?

It is still too early to determine what results are actually achieved from a PRP injection, according to experts. Dr. Hakman advises that you ask your doctor for more information about this treatment and local clinical trials. 

If it is already offered as a routine service at your fertility clinic, it’s important to remember that the research is not yet conclusive. "It's not like this big medical breakthrough,” says Dr. Hakman. 

While PRP may not work for every woman with infertility, it did seem to help Neckles. After PRP, she underwent an embryo transfer, and it took. Her son is now three weeks old.

Looking back, Neckles says she's glad she made the choice to go through with the procedure. "I wouldn't change any of it."