Medically Reviewed
By Dr. Puneet Rana Arora : Founder & Director, CIFAR — Centre for Infertility & Assisted Reproduction, Gurugram FRCOG (Royal College of Obstetricians & Gynaecologists, UK) | MSc Reproduction & Development, University of Bristol, UK
Last Review Date : 10 November, 2026
Insights from AOGD 2026 – 48th Annual Conference
Thin endometrium remains one of the most frustrating puzzles in reproductive medicine. Even with a perfectly timed embryo and optimal hormonal support, a lining that fails to grow adequately can quietly derail an otherwise well-planned IVF cycle. It’s a problem doctors see often — and one for which conventional protocols don’t always have an answer.
This challenge took centre stage at the AOGD 2026, 48th Annual Conference, during a lively Session 3 Debate titled “Platelet-Rich Plasma for Thin Endometrium: Promise or Placebo?” Representing CIFAR – Centre for InFertility and Assisted Reproduction, Dr. Puneet Rana Arora, Founder & Director of CIFAR, took the podium for the motion, making the case that PRP deserves a genuine place in the fertility toolkit — not as a miracle cure, but as a carefully considered option for the right patient.
The Clinical Problem: When the Lining Won’t Cooperate
A receptive endometrium is one of the fundamental requirements for embryo implantation. Yet a subset of patients — often those with a history of intrauterine adhesions, prior surgeries, chronic endometritis, or unexplained poor response to estrogen — simply do not achieve adequate endometrial thickness despite standard hormonal optimisation. For these patients, cycles are frequently cancelled, embryos are frozen and re-frozen, and the emotional and financial toll compounds with each attempt.
It’s precisely this unmet need that has pushed clinicians and researchers to explore adjunctive therapies — and PRP is one of the most talked-about among them.
What Is PRP, and Why the Interest?
Platelet-Rich Plasma is derived from a patient’s own blood, concentrated to contain a higher density of platelets than normal plasma. Platelets are rich in growth factors — including VEGF, PDGF, and TGF-β — that are known to play a role in tissue repair, angiogenesis, and cellular proliferation. The underlying hypothesis is straightforward: if growth factors can promote healing and regeneration elsewhere in the body, intrauterine infusion of PRP might similarly stimulate endometrial growth and improve receptivity in women with a persistently thin lining.
It’s an elegant theory — and one that has generated real enthusiasm in reproductive medicine circles. But elegant theories don’t always translate cleanly into consistent clinical outcomes, which is exactly why this topic was chosen for formal debate.
Dr. Puneet Rana Arora’s Point of View: The Case For PRP
Arguing for the motion, Dr. Arora built her case on a simple premise: absence of large-scale, definitive trials is not the same as absence of clinical value.
Her key points included:
- A plausible, well-supported biological mechanism. The growth factors concentrated in PRP have an established role in tissue regeneration, giving the therapy a rational scientific basis rather than being an unfounded intervention.
- Encouraging signals in difficult-to-treat patients. Dr. Arora highlighted that several observational studies and smaller trials have reported improved endometrial thickness and, in some cases, better implantation and pregnancy rates among women who had previously failed to respond to conventional treatments like extended estrogen therapy, vaginal sildenafil, or vitamin E.
- A reasonable safety profile. Because PRP is autologous — prepared from the patient’s own blood — the risk of immune reaction or transmissible infection is minimal, an important consideration when recommending any adjunct therapy.
- A therapy of last resort deserves a fair hearing. For patients who have exhausted standard options and are otherwise facing cycle cancellation or donor egg/surrogacy discussions, Dr. Arora argued that a low-risk intervention with plausible benefit merits consideration — provided it is offered with honest counselling about the current evidence base.
Her central message to the audience was not “PRP is proven” but rather that selective, well-counselled use in appropriately chosen patients is clinically defensible, especially when other options have failed.
Holding Space for the Other Side
A well-run debate exists precisely because reasonable clinicians can disagree — and the opposing side, arguing against the motion, raised valid concerns that are worth acknowledging: the existing evidence largely comes from small, heterogeneous studies with inconsistent protocols (volume, timing, number of infusions), few large randomised controlled trials, and a real risk of overselling an unproven therapy to emotionally vulnerable patients. These are not dismissible points, and they’re part of why PRP remains an adjunct under active investigation rather than a first-line, universally recommended treatment.
Where This Leaves Patients
The honest answer, as Dr. Arora’s own argument implied, is nuanced: PRP is not a guaranteed solution—but it isn’t without scientific evidence either . It sits in the space many fertility treatments occupy early in their evolution — biologically plausible, showing promising early signals, but still awaiting the large, well-designed trials that would settle the debate definitively.
For patients navigating thin endometrium, the real takeaway is less about PRP specifically and more about the importance of individualised care: a thorough work-up to identify why the lining isn’t responding, transparent conversations about what the evidence does and doesn’t show, and a treatment plan tailored to the specific case rather than a one-size-fits-all protocol.
The Question Worth Asking
As Dr. Arora put it in essence during the debate, the question isn’t simply “Does PRP work?” It’s:
Could PRP be a meaningful option for carefully selected patients with thin endometrium — used responsibly, with realistic expectations, as part of a broader, evidence-informed treatment strategy?
That’s the space in which CIFAR continues to practice: staying current with emerging research, engaging critically with new therapies rather than adopting them uncritically, and putting patients’ best interests — not hype — at the centre of every treatment decision.
Dr. Puneet Rana Arora is the Founder & Director of CIFAR – Centre for InFertility and Assisted Reproduction, Gurugram, and an FRCOG-trained reproductive medicine specialist with over a decade of experience at the NHS, UK.
