Combination Therapy With Platelet-Rich Plasma (PRP) and Granulocyte Colony-Stimulating Factor (G-CSF) for Thin Endometrium: A Case Report.

This case study highlights the challenges faced by a couple with a history of two failed in-vitro fertilization (IVF) attempts, including miscarriage and ectopic pregnancy. After treating the female partner for pelvic inflammatory disease (PID) with ceftriaxone and doxycycline, the decision was made to proceed with intra-cytoplasmic sperm injection (ICSI) and fresh embryo transfer. Despite the transfer of two good-quality (4AB and 3AA) day five embryos, the human chorionic gonadotropin (β-hCG) test yielded a negative result. Upon re-examination, a thin endometrium measuring 6.5mm was identified, prompting the implementation of the protocol for improvement of endometrial receptivity (PRIMER) protocol, which involves a combination of platelet-rich plasma (PRP) and granulocyte colony-stimulating factor (G-CSF). Following PRP administration and G-CSF injection, significant improvement was observed in the endometrial thickness. Subsequently, frozen embryo transfer (FET) was performed on day six of progesterone, resulting in a positive pregnancy outcome with a β-hCG level of 234 mIU/ml. Continuous adherence to instructions and ongoing administration of G-CSF until the 12th week of gestation remains important. This case underscores the efficacy of the PRIMER protocol in overcoming obstacles such as recurrent implantation failure (RIF) and achieving positive outcomes in assisted reproductive technology (ART).