The Value of Platelet-Rich Plasma Treatment in Reproductive Disorders: An Umbrella Review.

Platelet-rich plasma (PRP) is an autologous regenerative therapy investigated for improving endometrial receptivity, ovarian function, and reproductive outcomes. To address inconsistent findings across existing reviews, we conducted an umbrella review of systematic reviews and meta-analyses identified from PubMed, Embase, Web of Science, and the Cochrane Library, with evidence appraised using AMSTAR-2 and GRADE. Twenty-one reviews were included. In women with recurrent implantation failure, intrauterine PRP was associated with improved live birth, clinical pregnancy, and biochemical pregnancy rates. Similar benefits were observed in women with previous implantation failure and in assisted reproductive technology (ART) populations. PRP also modestly increased endometrial thickness and implantation rates. In women with thin endometrium or intrauterine adhesions, PRP improved pregnancy outcomes and reduced cycle cancellation, while miscarriage rates were largely unchanged. Intra-ovarian PRP improved ovarian reserve markers, hormone profiles, oocyte yield, and embryo quality in women with poor ovarian response, premature ovarian insufficiency, or diminished ovarian reserve, although effects on pregnancy and live birth were variable. Overall, PRP shows potential benefits, but the certainty of evidence ranged from very low to moderate due to heterogeneity and methodological limitations. High-quality randomized controlled trials are required to confirm efficacy and guide clinical practice.