The use of autologous platelet-rich plasma in embryo culture to obtain high-quality embryos.

Transferring high-quality embryos is crucial for in vitro fertilization success, as they lead to better clinical pregnancy and live birth outcomes. Researchers have investigated adding supplements to culture media to enhance embryo quality because culture conditions greatly affect embryo quality and development. This study assessed whether adding autologous platelet-rich plasma containing growth factors and cytokines to the culture media could produce more usable and high-grade embryos. This retrospective study analyzed 175 in vitro fertilization cycles from 123 women with poor embryo development or no usable embryos in previous cycles. 5% platelet-rich plasma solution was added to the cleavage-stage culture medium, and embryos were incubated for 48 h. Embryo development rates, stage-specific usable embryos, and high-quality embryo proportions were measured. Cytokine analysis was performed to compare the platelet-rich plasma samples from patients with high- and low-quality embryos. Adding autologous platelet-rich plasma significantly improved embryo development outcomes, with higher usable embryo rates compared to untreated groups. Platelet-rich plasma enhanced outcomes at the blastocyst stage and improved high-quality embryo rates at the morula and blastocyst stages. Both POSEIDON groups II and IV showed significantly better usable embryo ratios with platelet-rich plasma. Significant differences in cytokine expression levels were observed between platelet-rich plasma samples from patients with high- and low-quality embryo samples, with notable variations in Flt-3 ligand, interleukin-23, monocyte chemoattractant protein-3, and urokinase plasminogen activator receptor. The limitations of this study are retrospective design without a placebo control group and its small sample size. Nevertheless, our findings are valuable for patients with poor prognoses, showing improved embryo development outcomes. This offers opportunities for older patients with multiple failed in vitro fertilization attempts.