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富血小板血浆对反应不良患者的创新性管理病例系列

A Case Series on Platelet-Rich Plasma Revolutionary Management of Poor Responder Patients.

作者信息

Sfakianoudis Konstantinos, Simopoulou Mara, Nitsos Nikolaos, Rapani Anna, Pantou Agni, Vaxevanoglou Terpsithea, Kokkali Georgia, Koutsilieris Michael, Pantos Konstantinos

机构信息

Centre for Human Reproduction, Genesis Athens Clinic, Athens, Greece.

Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens,

出版信息

Gynecol Obstet Invest. 2019;84(1):99-106. doi: 10.1159/000491697. Epub 2018 Aug 22.

Abstract

Poor responders are described as those In Vitro Fertilization (IVF) patients who are failing to respond to controlled ovarian stimulation protocols. Extensive research has focused on crafting the optimal treatment. However, it appears that each approach fails to be established as effective or guaranteed towards successful management. Platelet-Rich Plasma (PRP) is a novel, highly promising approach that has been successfully applied for an array of medical issues. In this case series, we present 3 poor responder patients with the common denominator of: failed IVF attempts, poor oocyte yield, and poor embryo quality. The option of oocyte donation was rejected. All patients were treated with autologous PRP ovarian infusion following written consent. Within a 3-month interval, follicle-stimulating hormone decreased by 67.33%, while Anti-Müllerian hormone increased by 75.18%. These impressive results on the biochemical infertility markers alone are classified as a complete biological paradox, coupled by improved embryo quality. Results report a natural conception at 24 weeks, an uncomplicated healthy pregnancy at 17 weeks and a successful live birth. To our knowledge, this is the first time such an approach and results are reported, where PRP treatment on poor responders lead to overcoming their challenging reproductive barrier.

摘要

反应不良者被描述为那些对控制性卵巢刺激方案无反应的体外受精(IVF)患者。广泛的研究集中在制定最佳治疗方案上。然而,似乎每种方法都未能被确立为对成功治疗有效或有保证的方法。富血小板血浆(PRP)是一种新颖且极具前景的方法,已成功应用于一系列医学问题。在本病例系列中,我们展示了3例反应不良的患者,其共同特征为:体外受精尝试失败、卵母细胞产量低以及胚胎质量差。患者拒绝了卵母细胞捐赠选项。所有患者在签署书面同意书后接受了自体PRP卵巢灌注治疗。在3个月的间隔内,促卵泡激素下降了67.33%,而抗苗勒管激素增加了75.18%。仅这些关于生化不孕标志物的令人印象深刻的结果就被归类为一个完全的生物学悖论,同时胚胎质量也有所改善。结果报告显示,24周时自然受孕,17周时妊娠顺利且健康,最终成功分娩活婴。据我们所知,这是首次报道这样一种方法及结果,即对反应不良者进行PRP治疗能够克服其具有挑战性的生殖障碍。

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