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Fertility tests and procedures

Tests & Procedures

Fertility Tests & Procedures

Understanding the Cause and Planning the Next Step

If you have been trying to conceive without success, the cause may involve ovulation, ovarian reserve, the uterus, fallopian tubes, sperm factors, or a combination of factors affecting both partners.

The first step in reproductive care is therefore not necessarily IVF. Appropriate investigations help clarify your reproductive health before a treatment plan is recommended.

A comprehensive infertility assessment usually includes ovulation and ovarian reserve, the structure of the uterus and fallopian tubes, and semen analysis. Assessing both partners helps identify possible contributing factors more completely.

If investigations reveal uterine cavity abnormalities, endometriosis, pelvic adhesions, or other conditions that may affect fertility, your doctor may assess whether a surgical procedure would be appropriate.

Female Fertility Assessments

AMH and Ovarian Reserve Assessment

Anti-Müllerian hormone (AMH) is a commonly used marker of ovarian reserve.

A blood test helps estimate the number of recruitable follicles in the ovaries. Before egg freezing or IVF, it can also help predict the likely response to ovarian stimulation medication.

AMH mainly reflects ovarian reserve, rather than egg quality, and cannot independently determine the chance of natural pregnancy.

Learn more about:

  • AMH testing
  • Low AMH
  • High AMH
  • Ovarian reserve
  • Assessment before egg freezing
Learn About AMH Testing

Reproductive Hormone Testing

Depending on your menstrual patterns and reproductive needs, your doctor may arrange blood tests such as:

  • FSH — Follicle-stimulating hormone
  • LH — Luteinizing hormone
  • E2 — Estradiol
  • PRL — Prolactin
  • TSH — Thyroid-stimulating hormone
  • Progesterone

Each hormone provides different information, and some tests need to be timed within the menstrual cycle. Tests are selected according to menstrual regularity, possible ovulatory disorders, and treatment needs. Not everyone requires every test.

Transvaginal Ultrasound and Antral Follicle Count

Transvaginal ultrasound is commonly used to assess:

  • Uterine size and shape
  • The endometrium, or uterine lining
  • Ovarian size and structure
  • Antral follicle count (AFC)
  • Uterine fibroids
  • Ovarian cysts
  • Endometriomas

Both AFC and AMH help assess ovarian reserve and predict the likely response to stimulation before egg freezing or IVF.

Hysterosalpingography (HSG)

The fallopian tubes provide the pathway where sperm and egg usually meet.

Hysterosalpingography involves introducing contrast medium into the uterine cavity and taking images to assess:

The shape of the uterine cavity and whether both fallopian tubes are open.

It is usually scheduled after menstruation has ended and before ovulation. Pregnancy must be excluded before the examination.

Some patients experience brief lower abdominal cramping or discomfort similar to menstrual cramps when the contrast is introduced. The experience varies. Tubal patency is an important part of female infertility assessment, and HSG is a commonly used test.

Learn About HSG

Male Fertility Assessments

Semen Analysis

Fertility assessment should involve both partners.

Semen analysis is a fundamental part of evaluating male fertility. Reproductive medicine guidance recommends assessing the male partner alongside the female partner during an infertility evaluation.

Common measurements include:

  • Semen volume
  • Sperm concentration and total count
  • Sperm motility
  • Sperm morphology
  • Other semen characteristics

A single result may be influenced by abstinence duration, recent fever or illness, and whether the entire sample was collected. If results are abnormal, your doctor may recommend repeat testing or further male reproductive assessment.

Learn About Male Fertility Testing

Fertility-Related Surgery

Not every patient with infertility needs surgery.

The decision depends on medical history, ultrasound, HSG, and other findings. Invasive surgery is generally not performed routinely for infertility assessment without a clear clinical indication.

Hysteroscopy: Diagnosis and Treatment

Hysteroscopy uses a thin telescope passed through the vagina and cervix to view the inside of the uterus directly.

If an abnormality that may affect implantation or fertility is found, hysteroscopic treatment may be considered for:

  • Endometrial polyps
  • Selected submucosal fibroids
  • Intrauterine adhesions
  • Certain uterine cavity abnormalities
  • Other uterine cavity conditions requiring treatment

Hysteroscopy can be both diagnostic and therapeutic. The procedure and need for anesthesia depend on the size and location of the abnormality and the planned intervention.

Learn About Hysteroscopy

Laparoscopic Surgery

Laparoscopy uses small abdominal incisions to introduce a camera and surgical instruments, allowing examination of the pelvis, uterus, ovaries, and fallopian tubes.

When medically indicated, it may be used to assess or treat:

  • Endometriosis
  • Ovarian endometriomas or other ovarian conditions
  • Pelvic adhesions
  • Selected fallopian tube conditions
  • Other gynecological conditions that may affect fertility

Laparoscopy is not necessary for every patient with infertility. Symptoms, imaging findings, age, ovarian reserve, and reproductive plans are considered when weighing potential benefits and risks.

Learn About Laparoscopy

Egg Retrieval

Egg retrieval is an important step in egg freezing and IVF.

After ovarian stimulation, retrieval is scheduled when the follicles are ready. Under transvaginal ultrasound guidance, a needle collects follicular fluid, which is examined by the embryology laboratory to identify the eggs.

The procedure usually involves anesthesia or sedation. Observation and rest are required afterward according to the medical team’s instructions.

Egg retrieval is used in:

  • Egg freezing
  • In vitro fertilization (IVF)
  • Egg donation
Learn About Egg Retrieval

Which Fertility Tests Do I Need?

Everyone’s circumstances are different. More testing is not necessarily better.

Tests should be selected according to age, duration of trying to conceive, menstrual patterns, reproductive history, previous illness and surgery, and both partners’ reproductive health. Assessment generally begins with a systematic, cost-conscious, and minimally invasive approach, with further investigations guided by the findings.

Common Areas of Female Assessment

Ovarian Reserve

AMH, AFC, and relevant hormone tests.

Ovulation

Menstrual history, with hormone testing or ultrasound when indicated.

The Uterine Environment

Transvaginal ultrasound and further uterine cavity assessment if needed.

The Fallopian Tubes

HSG or another tubal patency assessment according to medical history.

Common Areas of Male Assessment

Semen Analysis

Assessment of sperm count, motility, and other semen characteristics.

Further Male Reproductive Assessment

If semen analysis is abnormal, hormone tests, imaging, genetic testing, or other investigations may be considered according to the findings.

Understanding the Findings Helps Guide Your Next Step

The purpose of fertility testing is not to assign blame, but to understand both partners’ reproductive health.

Some patients may benefit from identifying the fertile window or adjusting treatment. Others may need IUI or IVF, while some may first require treatment for uterine, tubal, or other reproductive conditions.

The Reproductive Medicine Center at Sung Jun Hung Women’s and Children’s Hospital provides male and female fertility assessments, reproductive imaging, and surgical treatment. Our team plans investigations and treatment according to individual needs, helping reduce unnecessary testing and give each step a clear purpose.

Book a Consultation
AMH testing and ovarian reserve assessment

AMH Testing & Ovarian Reserve Assessment

AMH Testing & Ovarian Reserve Assessment

Understanding Your Ovarian Reserve and Planning Ahead

Egg numbers decline with age, but the rate varies between individuals. AMH, AFC, and relevant hormone tests help assess ovarian reserve and inform planning for pregnancy, egg freezing, or assisted reproduction.

What Is AMH?

Anti-Müllerian hormone (AMH) is produced mainly by small follicles in the ovaries and is a commonly used marker of ovarian reserve.

It helps estimate the number of recruitable follicles and predict the response to ovarian stimulation. AMH can generally be tested at different times in the menstrual cycle, whereas baseline FSH and E2 are usually measured early in the cycle.

Does a Low AMH Mean I Cannot Get Pregnant?

No. AMH mainly reflects egg quantity. It does not directly measure egg quality or independently predict natural conception. Pregnancy may still occur with a low AMH if ovulation continues and other reproductive factors are favorable. Conversely, a normal or high AMH does not guarantee easy conception.

Avoid judging fertility solely by an online “normal AMH range.”

Antral Follicle Count (AFC)

AFC is usually measured by transvaginal ultrasound to count small follicles in both ovaries. Together with AMH, it helps assess ovarian reserve and predict the response to stimulation before egg freezing or IVF.

What Other Hormones May Be Tested?

Depending on your menstrual cycle, symptoms, and reproductive needs, your doctor may arrange FSH, LH, E2, TSH, prolactin, or progesterone testing.

Not every patient needs all of these tests. Testing is individualized according to menstrual regularity, ovulation, and medical history.

Is a Higher AMH Always Better?

Not necessarily.

A higher AMH usually indicates more small recruitable follicles. If it occurs with irregular periods, ovulatory problems, or other findings, further assessment for polycystic ovary-related conditions may be appropriate.

A high AMH and an expected high egg yield can also indicate an increased risk of ovarian hyperstimulation syndrome (OHSS). Medication is therefore adjusted according to individual ovarian function.

Fertility Assessment Is More Than One Number

A comprehensive assessment considers age, AMH, AFC, menstrual patterns, ovarian conditions, surgical history, previous treatment response, and current reproductive plans.

Hysterosalpingography examination

Hysterosalpingography

Hysterosalpingography (HSG)

Checking the Fallopian Tubes: Procedure and Preparation

The fallopian tubes are the pathway where sperm and egg usually meet. Blockage, adhesions, or previous infection may reduce the chance of natural conception.

HSG is a common infertility investigation that assesses the shape of the uterine cavity and whether both fallopian tubes are open.

When Might HSG Be Recommended?

It may be recommended if you have been trying to conceive without success, have a history of pelvic infection or tubal conditions, or need further assessment of tubal patency.

When Is the Best Time for the Test?

HSG is generally scheduled after menstruation has ended and before ovulation to avoid performing the test during a possible pregnancy. The exact date depends on your cycle and the hospital’s arrangements.

How Is the Test Performed?

A speculum is placed in the vagina, similar to a pelvic examination. A thin tube is then passed through the cervix, and contrast medium is introduced slowly into the uterus.

X-ray images track whether the contrast:

Fills the uterus → Passes through the tubes → Spills into the pelvis.

Free passage and spill of contrast generally indicate that the tube on that side is open.

Does HSG Hurt?

Introducing the contrast may cause lower abdominal cramping similar to menstrual cramps. It is usually brief, although the intensity varies.

Light spotting, discharge, or temporary abdominal discomfort may occur afterward.

Does an Apparent Blockage Always Mean the Tube Is Blocked?

Not necessarily.

In particular, apparent blockage near the uterine ends of both tubes may sometimes result from temporary muscular spasm or catheter positioning. Your doctor may recommend further confirmation based on the images and medical history rather than assuming permanent blockage.

When Might HSG Be Unsuitable?

Tell the medical team if you are pregnant, have an active pelvic infection, significant uterine bleeding, or a history of a moderate or severe contrast reaction. Your doctor will assess whether the test is appropriate.

Semen analysis

Semen Analysis

Semen Analysis

What Is Semen Analysis?

Semen analysis is an important test of male reproductive health. It measures characteristics such as semen volume, sperm concentration, motility, morphology, liquefaction time, and pH.

Both Partners Should Be Assessed

Infertility assessment is not limited to women. Male factors can also affect conception. Semen analysis helps identify potential concerns and guide further care.

Who May Benefit from Testing?

  • Couples who have tried to conceive for more than one year without success
  • Couples who have tried for more than six months when the female partner is 35 or older
  • Men with a history of infertility
  • Men who have had testicular, urinary tract, or inguinal surgery
  • Men with a varicocele
  • Men with sexual or ejaculatory difficulties
  • Men who have received chemotherapy or radiation therapy
  • Men planning sperm freezing

Semen Analysis Reference Values

1. Total Sperm Number

39 million per ejaculate.

2. Sperm Concentration

16 million per mL.

3. Total Motility

42% motile sperm.

4. Normal Morphology

4% normal forms.

5. Progressive Motility

30% progressively motile sperm.

6. Semen Volume

1.4 mL per ejaculate.

Preparing for the Test

  • Follow the center’s instructions to abstain from ejaculation for three to five days.
  • Avoid sleep deprivation, excessive fatigue, and heavy alcohol consumption before testing.
  • Tell your doctor about recent fever, infection, or current medications.
  • Follow the hospital’s instructions for collecting the sample.

The Testing Process

1. Clinical Assessment

Review of reproductive plans and medical history.

2. Sample Collection

Collection according to the hospital’s instructions.

3. Laboratory Analysis

Assessment of sperm count, motility, morphology, and other relevant characteristics.

4. Results Consultation

Your doctor explains the findings and recommends any next steps.

Frequently Asked Questions

Do I need to fast?

No. You may eat and drink normally before semen analysis.

Does an abnormal result mean I am infertile?

Not necessarily. Stress, sleep, infection, medication, and lifestyle can affect semen parameters. Your doctor will assess whether repeat testing or further care is needed.

Does a normal result guarantee pregnancy?

No. Pregnancy also depends on the female partner’s reproductive health, both partners’ overall health, and the timing of intercourse.

Understanding Male Fertility Starts with Semen Analysis

Sung Jun Hung Women’s and Children’s Hospital provides a professional testing environment that respects your privacy and helps you plan suitable next steps for conception or treatment.

Laparoscopic assessment and treatment

Laparoscopy

Laparoscopic Assessment & Treatment

Endometriosis, Endometriomas, and Pelvic Adhesions

Laparoscopy allows direct examination of the uterus, ovaries, fallopian tubes, and surrounding pelvic tissues. Some conditions can be treated during the same operation.

However, not every patient with infertility needs laparoscopy before treatment.

Which Conditions May Require Laparoscopy?

Examples include endometriosis, ovarian endometriomas, pelvic adhesions, selected tubal conditions, and other pelvic findings requiring surgical assessment after initial investigations.

How Is Laparoscopy Performed?

The procedure is usually performed under anesthesia. A camera and surgical instruments are introduced through small abdominal incisions.

Depending on the findings, treatment may include removal of endometriotic lesions, division of adhesions, ovarian cyst surgery, or selected tubal procedures.

Does Endometriosis Always Need Surgery Before IVF?

No.

The decision depends on pain, age, previous surgery, reproductive plans, other infertility factors, and ovarian reserve. Endometriosis alone is not a reason for every patient to undergo surgery.

For women preparing for assisted reproduction who have an ovarian endometrioma, routine surgery solely to improve IVF live birth rates is not recommended in the guidance described in the source article. Ovarian surgery itself may affect ovarian reserve.

When Might Surgery Still Be Considered?

Surgery may be discussed if pain is significant, a lesion requires diagnosis or treatment, a cyst interferes with egg retrieval, or the expected benefits outweigh the risks.

The aim is to balance the benefits of surgery with preservation of fertility, rather than simply removing every visible lesion.

Egg retrieval procedure and aftercare

Egg Retrieval: Procedure & Aftercare

Egg Retrieval: Procedure & Aftercare

What to Expect During Egg Freezing and IVF

Egg retrieval is an important step in egg freezing and IVF.

After ovarian stimulation and follicle monitoring, a final maturation injection is scheduled when the follicles are ready. Retrieval then takes place at a specified time.

What Happens Before Retrieval?

Stimulation medication is selected according to age, AMH, AFC, and any previous treatment response.

Transvaginal ultrasound and relevant blood tests monitor follicle growth and guide the timing of the final maturation injection.

Retrieval is generally scheduled approximately 34 to 38 hours after the injection, according to the treatment protocol. Timing is important: follow your medical team’s exact instructions for the injection and hospital arrival.

How Is Egg Retrieval Performed?

The procedure usually involves sedation or anesthesia.

Under transvaginal ultrasound guidance, a thin needle passes through the vaginal wall into the ovarian follicles to collect follicular fluid. The embryology laboratory then identifies the eggs.

The procedure is usually brief, although the duration varies with follicle number and individual circumstances.

Does Each Follicle Contain a Mature Egg?

Not necessarily.

Not every follicle seen on ultrasound yields an egg, and not every retrieved egg is mature.

Follicle count, the number of eggs retrieved, and the number of mature eggs are three different measurements.

What Symptoms May Occur After Retrieval?

Common symptoms include lower abdominal discomfort, bloating, light vaginal spotting, and fatigue after anesthesia.

Egg retrieval is invasive, and uncommon complications include bleeding and infection. Patients who have undergone ovarian stimulation also need to be aware of OHSS.

Contact the medical team promptly if abdominal pain or bloating worsens rapidly, or if you experience breathing difficulty, persistent vomiting, markedly reduced urine output, heavy bleeding, or fever.

Can I Drive Home After Retrieval?

If you receive sedation or anesthesia, do not drive or ride a scooter or motorcycle yourself. Follow the hospital’s instructions, arrange for someone to accompany you, and rest after returning home.

PRP and fertility treatment add-ons

PRP & Fertility Treatment Add-ons

PRP & Fertility Treatment Add-ons

Ovarian PRP: An Investigational Fertility Add-on

Improving the response to ovarian stimulation in women with diminished ovarian reserve or a low egg yield remains an area of research. Ovarian PRP involves preparing platelet-rich plasma from the patient’s own blood and injecting it into ovarian tissue. The proposed aim is to influence the local ovarian environment through growth factors, but its benefits remain uncertain.

What Is Ovarian PRP?

PRP stands for platelet-rich plasma. A sample of the patient’s blood is centrifuged and separated to prepare plasma containing a higher concentration of platelets and associated growth factors.

The PRP is injected into ovarian tissue using a thin needle under transvaginal ultrasound guidance. The proposed mechanism involves tissue repair, blood vessel formation, and changes in the local environment that might affect subsequent ovarian response. These proposed effects have not been established as reliable clinical benefits.

Using the patient’s own blood reduces concerns related to donor-derived material, but does not eliminate procedural risks.

What Is Ovarian PRP Being Studied For?

Research has explored whether ovarian PRP might:

  • Influence local ovarian tissue and blood circulation
  • Improve the response to stimulation medication
  • Increase egg yield in subsequent cycles
  • Offer an additional approach for patients with a poor ovarian response

These are proposed research goals rather than established outcomes. Age, ovarian reserve, AFC, and egg quality differ between patients, and treatment responses may vary.

Who May Ask About Ovarian PRP?

A fertility specialist may discuss the evidence and limitations with patients who have:

  • Low AMH or diminished ovarian reserve
  • A low AFC
  • A poor response to previous ovarian stimulation
  • A low egg yield in previous retrieval cycles
  • Questions about additional options before another IVF cycle

These findings do not automatically make someone a suitable candidate. Assessment must consider age, hormone tests, ultrasound, previous treatment records, overall health, and the uncertainties surrounding the procedure.

The Ovarian PRP Procedure

1. Fertility and General Health Assessment

The doctor reviews AMH, FSH, AFC, and previous retrieval records. Blood tests, coagulation tests, or other assessments may be arranged when needed.

2. Blood Collection and PRP Preparation

A blood sample is collected and processed using dedicated centrifugation and separation equipment.

3. Ultrasound-Guided Injection

PRP is injected into the ovaries under transvaginal ultrasound guidance. Anesthesia or pain relief depends on individual circumstances and the planned procedure.

4. Observation and Discharge

Rest and observation are required afterward. Patients may return home when stable. Mild lower abdominal discomfort or light bleeding may occur.

5. Follow-Up and Further Treatment Planning

Blood tests, ultrasound, or subsequent stimulation are planned according to ovarian function, menstrual patterns, and the individual treatment plan. Timing varies.

Before and After the Procedure

Tell your doctor about all medications, supplements, and medical conditions, particularly anticoagulants, coagulation disorders, platelet conditions, or infection.

Afterward:

  • Rest and attend follow-up as instructed
  • Temporarily avoid strenuous exercise and heavy lifting
  • Monitor abdominal pain, bleeding, and temperature
  • Do not stop or change medication without medical advice

Seek prompt medical assessment for persistent or severe abdominal pain, heavy bleeding, fever, or dizziness.

Can Ovarian PRP Improve Egg Quality or Pregnancy Rates?

Ovarian PRP remains an investigational fertility add-on. Some studies have reported changes in ovarian response or egg yield, but sufficient, consistent, high-quality evidence is lacking to establish improvements in egg quality, embryo quality, pregnancy rates, or live birth rates.

The source article refers to the Human Fertilisation and Embryology Authority’s concerns about limited evidence and uncertainty regarding effects on eggs, embryos, and long-term outcomes. It also refers to European Society of Human Reproduction and Embryology guidance emphasizing disclosure of evidence, risks, and uncertainties before using treatment add-ons.

Ovarian PRP should not be presented as a way to reverse ovarian aging, create new eggs, or guarantee pregnancy. It does not replace standard fertility care or IVF. Any decision requires an individualized assessment and a clear discussion of possible benefits, risks, and research limitations.

Endometrial Scratching: Understanding the Procedure and Evidence

Implantation depends on embryo factors as well as the uterine lining, uterine cavity, and timing of transfer. After unsuccessful embryo transfers, the doctor may investigate possible causes and assess whether hysteroscopy or another procedure is appropriate. Endometrial scratching is a separate add-on procedure and does not involve PRP.

What Is Endometrial Scratching?

In the approach described here, hysteroscopy is used to inspect the uterine cavity and guide a controlled mechanical disturbance of the endometrium.

The proposed mechanism is that a mild injury may trigger local repair and inflammatory responses, changing cytokines, growth factors, and other substances potentially involved in implantation. A clinical benefit has not been consistently demonstrated.

Hysteroscopy also allows inspection for polyps, adhesions, submucosal fibroids, or findings that may require further assessment for inflammation or other abnormalities.

What Are the Proposed Aims?

The combined assessment and procedure described in the source may aim to:

  • Inspect the uterine cavity and endometrial surface directly
  • Identify subtle cavity abnormalities that may be difficult to assess by ultrasound
  • Trigger a local repair response through mechanical stimulation
  • Assess and address uterine cavity factors that may affect implantation
  • Support individualized preparation for a subsequent embryo transfer

The diagnostic role of hysteroscopy is distinct from the uncertain benefit of scratching. Unsuccessful implantation may involve embryo chromosomes, uterine conditions, hormonal factors, or other clinical issues. Scratching cannot address every possible cause.

Who May Discuss Further Uterine Assessment?

A specialist may review the need for assessment in patients with:

  • Repeated unsuccessful embryo transfers
  • Suspected uterine cavity or endometrial abnormalities
  • A history of polyps, intrauterine adhesions, or submucosal fibroids
  • Ultrasound findings that do not fully clarify the uterine cavity
  • A clinical reason for further investigation of the implantation environment
  • A planned repeat embryo transfer requiring review of previous findings

The need for hysteroscopy and the separate question of whether to perform scratching should be considered individually. Not every patient undergoing IVF needs either procedure.

How Is the Procedure Performed?

1. Pre-procedure Assessment

The doctor reviews IVF and transfer records, menstrual patterns, uterine history, ultrasound, and other relevant findings to assess the indication and timing.

2. Hysteroscopy

A thin hysteroscope passes through the vagina and cervix to inspect the uterine lining, cavity shape, and tubal openings.

3. Targeted Mechanical Stimulation

If planned, controlled endometrial stimulation is performed at a selected site. Whether polyps, adhesions, or other abnormalities can be treated at the same visit depends on their size, the procedure, consent, and anesthesia arrangements.

4. Observation

Mild lower abdominal discomfort or light spotting may occur. Patients return home when stable, following the doctor’s instructions.

5. Planning the Next Transfer

Medication, monitoring, and transfer timing are arranged according to the menstrual cycle, recovery, and treatment plan.

Before and After the Procedure

Tell your doctor about possible pregnancy, anticoagulant use, previous reactions to anesthesia, bleeding disorders, or pelvic infection. If anesthesia is planned, follow the team’s fasting instructions.

Afterward:

  • Rest and take medication as prescribed
  • Temporarily avoid strenuous exercise, soaking in a bath, and swimming
  • Follow instructions about intercourse and vaginal medication
  • Monitor pain, bleeding, discharge, and temperature
  • Attend scheduled follow-up

Seek prompt assessment for heavy bleeding, worsening abdominal pain, fever, chills, dizziness, or foul-smelling discharge.

Does Endometrial Scratching Improve Implantation?

The theory is that a local repair response might improve endometrial receptivity. However, study results are inconsistent, and a general improvement in implantation, pregnancy, or live birth has not been established.

The source article cites the Human Fertilisation and Embryology Authority’s assessment that findings vary in IVF and ICSI populations, with insufficient moderate- or high-quality evidence to demonstrate improved birth outcomes in patients with repeated implantation failure.

Scratching is not a routine requirement for every patient and cannot guarantee implantation or pregnancy. Decisions should distinguish the diagnostic value of hysteroscopy from the uncertain benefit of scratching and include discussion of risks and evidence limitations.

Intrauterine PRP Infusion: An Investigational Endometrial Add-on

Embryo implantation involves embryo quality as well as endometrial thickness, blood flow, and receptivity. Some patients have a persistently thin lining, limited endometrial growth, or repeated unsuccessful transfers. Intrauterine PRP has been investigated as an add-on in these settings, but its benefits remain uncertain.

What Is Intrauterine PRP Infusion?

PRP stands for platelet-rich plasma. A sample of the patient’s own blood is centrifuged and separated to prepare platelet-rich plasma, which is then introduced into the uterine cavity through a thin catheter.

The proposed mechanism involves growth factors released by platelets that might support endometrial repair, growth, and blood vessel formation. These proposed mechanisms do not establish improved pregnancy or live birth outcomes.

The preparation comes from the patient’s own blood and contains no donor blood components. This reduces concerns related to donor-derived material but does not eliminate procedural risks.

What Is Intrauterine PRP Being Studied For?

Proposed research goals include:

  • Supporting endometrial tissue repair and growth
  • Increasing thickness in a persistently thin endometrium
  • Influencing local endometrial blood circulation
  • Improving endometrial receptivity
  • Preparing the uterine environment for embryo transfer

These are potential aims rather than guaranteed effects. Response may vary with age, the cause of a thin lining, uterine cavity conditions, embryo quality, and hormonal response.

Who May Ask About Intrauterine PRP?

A fertility specialist may discuss the evidence and uncertainties with patients who have:

  • A persistently thin endometrium
  • Limited endometrial growth despite hormonal treatment
  • Transfers previously delayed or canceled because of an insufficient lining
  • Repeated unsuccessful embryo transfers
  • A history of uterine cavity surgery or adhesions
  • Suspected endometrial receptivity concerns

These findings do not automatically justify PRP. Possible causes such as polyps, adhesions, submucosal fibroids, chronic endometritis, hormonal conditions, and embryo factors should first be considered when planning care.

The Intrauterine PRP Procedure

1. Pre-procedure Assessment

The doctor reviews menstrual patterns, endometrial thickness, previous transfers, and medical history. Transvaginal ultrasound is performed, with hysteroscopy or other tests considered if indicated.

2. Blood Collection and PRP Preparation

A blood sample is collected and processed using dedicated centrifugation and separation equipment.

3. Intrauterine Infusion

A thin catheter passes through the vagina and cervix into the uterus, where PRP is slowly introduced. The process resembles catheter placement during IUI or embryo transfer. Anesthesia is usually not required, although arrangements depend on individual circumstances.

4. Brief Rest and Discharge

Patients may return home after observation if there is no significant discomfort. Mild cramping, spotting, or increased discharge may occur.

5. Monitoring and Transfer Planning

Ultrasound is used to reassess endometrial thickness and appearance. Further medication, any proposed repeat infusion, and transfer timing are discussed according to the treatment plan.

Before and After the Procedure

Tell your doctor about medications, supplements, platelet conditions, bleeding disorders, anticoagulant use, uterine infection, and other significant medical conditions.

Afterward:

  • Use hormonal and other medication as instructed
  • Avoid strenuous exercise and heavy lifting on the day
  • Do not stop medication or change doses without medical advice
  • Attend scheduled endometrial monitoring
  • Monitor pain, bleeding, discharge, and temperature

Seek prompt assessment for worsening abdominal pain, heavy bleeding, fever, chills, or foul-smelling discharge.

Does Intrauterine PRP Improve Implantation?

Some studies have reported increased endometrial thickness in selected patients. However, study populations, PRP preparation, infusion schedules, and treatment protocols vary. Evidence is insufficient to establish a general improvement in implantation, clinical pregnancy, or live birth rates.

The source article cites the Human Fertilisation and Embryology Authority’s concerns about limited evidence and the need for further research into reproductive and long-term outcomes.

Intrauterine PRP is not required for every IVF patient and cannot guarantee a thicker lining or a successful pregnancy. Any decision should consider endometrial and uterine findings, embryo factors, previous treatment, possible benefits, risks, and the limitations of available evidence.

This information is provided for patient education. Indications, timing, treatment methods, and potential risks require individualized assessment by a fertility specialist.

CONSULTATION

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