What is PRP?
Platelet-rich plasma (PRP) is a concentrate made from your own blood. A small blood sample is drawn and spun in a centrifuge to separate the platelets- small blood cells that contain natural growth factors involved in healing and tissue repair. The resulting PRP is then injected into a target area, such as the ovary or the uterine lining.
PRP has been used in orthopedics and sports medicine for years. More recently, PRP has been used as a potential treatment to improve egg production or help embryos implantation. But what does the science actually say, especially for women with endometriosis?
Endometriosis and Fertility: A Quick Refresher
Endometriosis is a condition where tissue similar to the uterine lining grows outside the uterus. It can affect fertility in several ways:
- Inflammation in the pelvis can interfere with egg quality and embryo implantation
- Scar tissue, caused by chronic inflammation, can mechanically prevent egg transfer from the ovary to the uterus
- Endometriomas (ovarian cysts caused by endometriosis) can damage healthy ovarian tissue
- Surgery to remove endometriomas, while often necessary, can further reduce the number of eggs your ovaries can produce
Because of these challenges, many women with endometriosis seek out new treatments, and PRP is one that has generated interest.
What Does the Research Say About PRP for Endometriosis and Fertility?
The honest answer: very little research has been done on PRP specifically for women with endometriosis who are trying to conceive.
Here is what we know so far:
PRP during endometrioma surgery
When surgeons remove endometriomas from the ovary, some healthy ovarian tissue may be lost, which can reduce your ovarian reserve, the number of eggs you have available. One small study of 71 women under age 35 looked at whether injecting PRP into the ovary during endometrioma surgery could help protect ovarian reserve. Women who received PRP maintained their hormone levels (AMH, a marker of egg supply) at 3 and 6 months after surgery, while those who did not receive PRP saw a significant drop. However, this study did not track whether PRP actually led to more pregnancies or births, and it was not a randomized controlled trial, the gold standard for medical evidence.
PRP for fertility in endometriosis without endometriomas
No studies have been conducted on PRP for fertility specifically in women who have endometriosis but do not have endometriomas. There is simply no data to support or refute its use in this group.
PRP in general fertility treatment (not specific to endometriosis)
PRP has been studied more broadly in women undergoing IVF or other fertility treatments, particularly for:
- Recurrent implantation failure (when embryos repeatedly fail to implant)
- Thin uterine lining
- Low ovarian reserve
Results from these studies have been mixed. A major review of 12 clinical trials found very low-quality evidence suggesting intrauterine and intraovarian infusion/injection of PRP might improve pregnancy rates in infertile women undergoing IVF. There was also a possible increase in preterm delivery risk, which is concerning.
For low ovarian reserve, studies have shown some improvement in hormone levels after PRP injection into the ovaries, but well-designed controlled studies have not consistently shown that this leads to more eggs or better pregnancy outcomes.
Are there Safety Concerns?
Because PRP is made from your own blood, the risk of allergic reaction or infection is low. However, there are important considerations for women with endometriosis:
- Endometriosis is driven in part by inflammation and the growth of new blood vessels. PRP contains growth factors that promote blood vessel formation and tissue growth. There is a theoretical concern that PRP could stimulate the growth of endometriosis lesions, although this has not been proven in humans.
- The injection procedure itself (into the ovary or uterus) carries small risks of bleeding, infection, or discomfort.
- Long-term safety data are lacking.
The Bottom Line
- PRP for fertility in women with endometriosis is experimental. It is not an established or proven treatment.
- The only endometriosis-specific study suggests PRP may help protect ovarian reserve during endometrioma surgery, but no pregnancy or birth outcomes have been reported.
- No studies have tested PRP for fertility in women with endometriosis who do not have endometriomas.
- Broader fertility studies on PRP show mixed results and are based on low-quality evidence.
- Major medical organizations have not endorsed PRP as a standard fertility treatment.
A Note on Making Informed Decisions
It is natural to want to try every available option when facing fertility challenges. However, treatments that lack strong evidence may not only be ineffective, they can also delay proven treatments, add financial burdens, and carry unknown risks. The best decisions are made in partnership with your medical team, based on the most current and reliable evidence available.
Talk to your doctor about what treatment plan is best supported by evidence for your individual situation.