Intrauterine platelet-rich plasma and subsequent endometrial pathology evaluation in a patient undergoing a frozen embryo transfer cycle: a case report.

backgroundPlatelet-rich plasma (PRP) is increasingly used for refractory thin endometrium and recurrent implantation failure, yet its histological effects remain poorly characterized. We report a case of longstanding infertility in which intrauterine PRP was administered during a frozen embryo transfer cycle that was subsequently cancelled, permitting pathological evaluation.

methodsClinical history, ultrasound findings, treatment cycles, and endometrial responses were reviewed. A pre‑PRP endometrial specimen was obtained during endometrial polyp removal, and a post‑PRP specimen was collected following an endometrial scratch. Biopsies before and after PRP were evaluated for histopathological features, including neovascularization, stromal remodeling, and immune cell infiltration. Ultrasound parameters, particularly endometrial thickness and a triple-line pattern, were compared with those from a prior PRP cycle.

resultsAfter PRP treatment, endometrial thickness went from 8.60 to 9.15 mm without a triple-line pattern. Histology showed a weakly proliferative endometrium with no evidence of enhanced vascularity, inflammatory infiltration, or structural remodeling. Findings were unchanged compared with the endometrium without PRP exposure. Overall, no discernible tissue-level changes were identified following PRP.

conclusionsIn this case, intrauterine PRP was not associated with detectable histological alterations. These findings suggest a potential disconnect between ultrasound‑measured endometrial thickness and underlying tissue response. Further mechanistic studies are warranted.