Successful Implantation and Live Birth Following Autologous Platelet-rich Plasma Treatment for a Patient with Recurrent Implantation Failure and Chronic Endometritis

Abstract

Background/aim: Patients diagnosed with chronic endometritis (CE) may fail to respond to standard antibiotic treatment. The driver behind the approach reported here was the imperative need for alternative therapeutic solutions.

Case report: This case report presents a woman with CE and premature ovarian insufficiency having experienced repeated implantation failures following donated embryo transfers. The patient was diagnosed with CE through hysteroscopy, microbiological analysis and scanning electron microscopy. Following the suggested antibiotic treatment, she underwent a new embryo transfer, but with subsequent pregnancy loss. Following a second antibiotic scheme, all diagnostic procedures certified the persistence of CE. The patient underwent autologous, intrauterine platelet-rich plasma treatment and a subsequent embryo transfer. The diagnostic procedures indicated no signs of CE, while the embryo transfer resulted in a twin pregnancy and birth.

Conclusion: Platelet-rich plasma may be employed as a first-line CE treatment, especially for patients who fail to respond to conventional antibiotic schemes.

Keywords: Chronic endometritis; IVF; PRP; implantation failure; inflammation; pregnancy.

Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Figures

Figure 1. Scanning electron microscopy analysis of the patient’s inner endometrial lining at the luteal phase of the menstrual cycle after the second antimycotic scheme (A and B) and after platelet-rich plasma (PRP) treatment (C and D). A: Two gland orifices of the infected endometrial epithelium are visible, containing mucus and blood cells. Clusters of mucus are also present on the epithelium surface (magnification ×750). B: Fungal spores, red blood cells and mucus in endometrial biopsy. The hyphae are in contact with the epithelial cells, fusing with some of them (magnification ×2,700). C: Normal endometrial epithelium morphology was apparent following PRP treatment (magnification ×750). D: Presence of pinopodes in the cured endometrial epithelium following PRP treatment (magnification ×2,700).