Cellular Therapy

Cellular Therapy: A Supportive Approach for the Uterus in Recurrent Miscarriages

Cellular therapy is a treatment approach based on processing biological material obtained from the patient’s own body and applying it to the target tissue. In reproductive medicine, it is receiving growing interest, especially in cases unresponsive to conventional methods, such as thin endometrium (uterine lining) and recurrent pregnancy loss. The most widely applied method in this field is intrauterine PRP (Platelet Rich Plasma) therapy. In Ankara, Obstetrics and Gynecology Specialist Prof. Dr. Melahat Atasever offers PRP within the framework of current scientific evidence and with individual patient evaluation.

What Is Cellular Therapy?

Cellular therapy is the use, for therapeutic purposes, of biological products obtained from the patient’s own cells or from a compatible donor. In reproductive health, this concept covers a range of different methods, such as PRP, mesenchymal stem cell applications, and exosome-based approaches. In clinical practice, the most common method with the strongest scientific basis is the application of PRP obtained from the patient’s own blood into the uterus (intrauterine).

The great majority of cellular therapies are still in the research process, and for many of them no standard treatment protocol has been established. For this reason, Prof. Dr. Melahat Atasever offers these applications only in cases unresponsive to conventional treatments, with complete patient information and according to strong scientific evidence support.

What Is PRP (Platelet Rich Plasma)?

PRP is a special plasma obtained from the person’s own blood, with a platelet concentration 3-5 times higher than normal blood. Through the growth factors they contain (PDGF, TGF-beta, VEGF, EGF, IGF-1), platelets stimulate cell proliferation, tissue repair, and vasculogenesis (the formation of new blood vessels). These bioactive properties make PRP stand out as a promising agent for endometrial regeneration.

In autologous PRP — that is, PRP prepared from the person’s own blood — the risk of allergic reaction is extremely low. It is a very advantageous agent in terms of its biological safety profile. The preparation process takes approximately 15-20 minutes and can be carried out at the clinic.

Recurrent Miscarriage and PRP

Recurrent pregnancy loss (RPL) is the experience of two or more consecutive clinical pregnancy losses. Embryo chromosomal anomalies, anatomical factors, thrombophilias, and autoimmune disorders are among the most common causes. However, in a considerable proportion of cases no cause can be identified; this group is defined as “unexplained recurrent miscarriage.”

In cases of unexplained recurrent miscarriage, uterine receptivity and local immune dysregulation are the focus of current research. Intrauterine PRP application, thanks to its growth factors, supports endometrial regeneration and microcirculation; it may also contribute to the modulation of the local immune environment. Pilot studies and case series report that this approach offers promising results, while large-scale randomized trials are still ongoing.

Thin Endometrium and PRP Therapy

A thin endometrium is an important factor that negatively affects embryo implantation; a uterine lining thickness below seven millimeters is evaluated as insufficient. A uterine lining thinned by previous curettage, infection, Asherman’s syndrome, or hormonal causes may not respond to standard estrogen therapy. In these resistant thin endometrium cases, intrauterine PRP offers a complementary or alternative option for increasing the thickness of the uterine lining.

Published series report that endometrial thickness increased significantly after PRP and that pregnancy was achieved in some patients. Prof. Dr. Melahat Atasever evaluates thin endometrium cases individually and considers PRP when there is no response to standard treatments.

Who Can Receive PRP in IVF Treatment?

In the IVF process, PRP is used in two different areas. Endometrial PRP is applied to increase endometrial receptivity in women experiencing recurrent IVF transfer failure and those with a thin endometrium. Ovarian PRP, on the other hand, is applied simultaneously with the egg retrieval procedure in women with low ovarian reserve, with the aim of obtaining more eggs in the next IVF cycle.

The most suitable candidate profile for this application has one or more of the following characteristics: two or more IVF failures, a thin endometrium (below 7 mm), unexplained recurrent miscarriage, or an insufficient endometrial response to standard treatments. Prof. Dr. Melahat Atasever carries out a comprehensive evaluation and guides you in determining whether PRP would contribute to your clinical picture.

Blood Collection and PRP Preparation

20-30 ml of blood is taken from the person’s arm. The blood is transferred into special tubes and processed in a centrifuge device, and the PRP is separated from the platelet-rich plasma layer. Preparation takes approximately 15-20 minutes.

Application into the Uterus

The prepared PRP is injected into the uterine cavity through a thin catheter. The procedure is carried out in a manner similar to IUI; no anesthesia is required, and it is completed within 5-10 minutes.

Application Timing and the Correct Protocol

PRP is applied during the endometrial growth phase, generally between days 8-10 of the cycle. In some protocols, two sessions are planned within the cycle. Afterwards, endometrial thickness is evaluated by ultrasound; embryo transfer or timed intercourse is planned in light of these findings.

Follow-Up After the PRP Application

After the PRP application, light spotting or discomfort may last one or two days; this is normal. Normal daily activities can be resumed from the day after the procedure. The endometrial response is monitored with transvaginal ultrasound; a thickness of 7 mm and above is considered a sufficient response. In cases requiring progesterone support, an extra protocol is added according to the IVF or IUI process.

Advantages and Limitations of Cellular Therapy

With autologous PRP, the risk of allergic reaction is extremely low; since it is minimally invasive, it does not require hospitalization, and daily life can be resumed immediately. Its side effect profile is quite limited compared to conventional medications. On the other hand, the standard PRP protocol has not yet been fully established; the preparation method, concentration, number of sessions, and timing vary from clinic to clinic. Large randomized trials are ongoing, and although the current evidence is promising, the final efficacy results are awaited.

Cellular Therapy in Ankara with Prof. Dr. Melahat Atasever

For cases that have not responded to other treatments due to recurrent miscarriage, thin endometrium, or recurrent IVF failure, you can consult Prof. Dr. Melahat Atasever in Ankara. After a comprehensive evaluation, it is determined whether cellular therapy is suitable for you; a treatment plan shaped by individual patient circumstances is offered within the framework of current scientific knowledge. You can contact our clinic for an appointment.