Effectiveness of Combined PRP Therapy in Women with Histologically and Immunohistochemically Confirmed Chronic Endometritis

Objective: To evaluate the effectiveness of combined platelet-rich plasma (PRP) therapy administered both intrauterine and paracervically in women with histologically and immunohistochemically confirmed chronic endometritis (CE).The aim of the study: was to evaluate the effectiveness of combination therapy with autologous platelet-rich plasma (PRP), administered simultaneously intrauterine and paracervically, in women with histologically and immunohistochemically confirmed chronic endometritis (E). Materials and Methods: The study included 225 reproductive-aged women with confirmed CE based on histological and immunohistochemical examinations of endometrial biopsies. All the patients received PRP therapy using a combined intrauterine and paracervical administration protocol. Treatment effectiveness was assessed 6–8 weeks post-therapy using repeated histological and immunohistochemical analyses (CD138, CD56, CD20, and Ki-67). Additionally, clinical pregnancy rates were analyzed in a subgroup of women attempting to conceive.Results: Complete morphological remission of CE was achieved in 76% of the patients. CD138-positive cells decreased or disappeared in 92% of the cases. A substantial proportion of women showed normalization of CD56 and CD20 expression as well as a reduced Ki-67 proliferation index. Among the women attempting conception (n = 104), clinical pregnancy occurred in 59.6%, with 82% resulting from spontaneous conception. Conclusions: Combined PRP therapy is an effective treatment for chronic endometritis and contributes to improved reproductive outcomes in women of reproductive age, particularly in cases of therapeutic failure.