Intrauterine Infusion of Platelet-Rich Plasma versus Granulocyte Colony-Stimulating Factor for Refractory Thin Endometrium in IVF Cycles

International Journal of Obstetrics and Gynecology | Vol. 14, No. 9, September 2026 | pp. 1083–1094

DOI: 10.46882/2026/IJOG/000571

Original Research Article

Title: Intrauterine Infusion of Platelet-Rich Plasma versus Granulocyte Colony-Stimulating Factor for Refractory Thin Endometrium in IVF Cycles

Names of Authors: Frederik Poulsen¹, Mariana Silva²

Authors’ Affiliations:
¹ Department of Obstetrics and Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
² Department of Obstetrics and Gynecology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

Abstract:
A persistently thin endometrium (< 7 mm) severely impairs pregnancy rates during frozen embryo transfer (FET) cycles. This prospective comparative clinical trial investigated the therapeutic efficacy of local intrauterine infusions of autologous Platelet-Rich Plasma (PRP) versus recombinant Granulocyte Colony-Stimulating Factor (G-CSF) in expanding endometrial thickness. One hundred subfertile women with a history of recurrent thin endometrium despite maximal oral estradiol therapy were assigned to receive either intrauterine PRP infusions (two doses on cycle days 10 and 12; n = 50) or a single intrauterine G-CSF infusion (on cycle day 11; n = 50). Endometrial structural dynamics were tracked via transvaginal ultrasound. Mean endometrial thickness increased significantly in both arms from baseline (p < 0.001). However, the PRP group achieved a significantly greater mean endometrial thickness on the day of progesterone initiation compared to the G-CSF cohort (7.8 ± 0.5 mm vs. 7.1 ± 0.4 mm, p < 0.001). Cycle cancellation rates due to inadequate endometrial expansion were lower in the PRP branch (2.0% vs. 12.0%, p = 0.043). Crucially, the clinical pregnancy rate per embryo transfer trended higher in the PRP cohort (43.8% vs. 29.5%, p = 0.048). Intrauterine infusion of autologous platelet-rich plasma provides a superior mucosal proliferative effect, optimizing endometrial thickness and lowering cancellation metrics in thin-endometrium FET cycles compared to G-CSF.

Keywords: Thin Endometrium; Platelet-Rich Plasma; Granulocyte Colony-Stimulating Factor; Frozen Embryo Transfer; Endometrial Thickness; Assisted Reproduction.

Manuscript Timeline: Received: July 18, 2026; Revised: September 06, 2026; Accepted: September 19, 2026; Published: September 28, 2026.

Citation: Poulsen F, Silva M. Intrauterine Infusion of Platelet-Rich Plasma versus Granulocyte Colony-Stimulating Factor for Refractory Thin Endometrium in IVF Cycles. International Journal of Obstetrics and Gynecology. 2026; 14(9): 1083–1094.

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