Platelet-rich plasma (PRP) vs granulocyte colony-stimulating factor (G-CSF) in women with thin endometrium undergoing assisted reproduction: a systematic review and meta-analysis

ABSTRACT
Objective. The aim of this study is to evaluate the effect of intrauterine infusion of platelet-rich plasma (PRP) vs granulocyte colony-stimulating factor (G-CSF) on endometrial thickness, clinical pregnancy rate, and live-birth rate.
Materials and Methods. Systematic searches were conducted on PubMed, Scopus, Cochrane Library, ClinicalTrials.gov and Google Scholar. The following keywords were used: “PRP” AND “G-CSF” AND “endometrium”. Meta-analysis was performed using RevMan software.
Results. A total of eight studies were therefore included in the final analysis, yielding a total of 479 patients. The primary analysis that focused on endometrial thickness was done as a meta-analysis of two studies that report endometrial thickness in their trials. (RR 1.08, 95%CI 0.80-1.45, p = 0.63). The secondary analysis was conducted to compare biochemical pregnancy rate (RR 1,31, 95%CI 1.06-1.62, p = 0.01). In the third analysis, we compared the rates of achieving clinical pregnancy in patients treated with PRP with those treated with G-CSF. (RR 1.30, 95 CI 1.00-1.70, p = 0.05) The heterogeneity for this comparison was 34%, which reflects the possible benefit of the PRP technique in relation to reproductive outcomes in patients with repeated implantation failures.
Conclusions. Based on our meta-analysis, PRP therapy significantly affects pregnancy rates in patients with thin endometrium compared to G-CSF. However, there was no statistically significant difference in endometrial thickening.