Nazari Leila, Salehpour Saghar, Hoseini Sedighe, Zadehmodarres Shahrzad, Azargashb Eznoallah
Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Health and Social Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Reprod Biomed. 2019 Jul 29;17(6):443-448. doi: 10.18502/ijrm.v17i6.4816. eCollection 2019 Jun.
Adequate endometrial growth is principal for implantation and pregnancy. Thin endometrium is associated with lower pregnancy rate in assisted reproductive technology. Some frozen-thawed embryo transfer cycles are cancelled due to inadequate endometrial growth.
To assess the effectiveness of autologous platelet-rich plasma (PRP) intrauterine infusion for the treatment of thin endometrium.
A total of 72 patients who had a history of cancelled frozen-thawed embryo transfer cycle due to the thin endometrium ( 7mm) were assessed for the eligibility to enter the study between 2016 and 2017. Twelve patients were excluded for different reasons, and 60 included patients were randomly assigned to PRP or sham-catheter groups in a double-blind manner. Hormone replacement therapy was administered for endometrial preparation in all participants. PRP intrauterine infusion or shamcatheter was performed on day 11-12 due to the thin endometrium and it was repeated after 48 hr if necessary.
Endometrial thickness increased at 48 hr after the first intervention in both groups. All participants needed second intervention due to an inadequate endometrial expansion. After second intervention, endometrial thickness was 7.21 0.18 and 5.76 0.97 mm in the PRP group and sham-catheter group, respectively. There was a significant difference between the two groups. (p 0.001). Embryo transfer was done for all patients in PRP group and just in six cases in the sham-catheter group. Chemical pregnancy was reported in twelve cases in the PRP group and two cases in the sham-catheter group.
According to this trial, PRP was effective in endometrial expansion in patients with refractory thin endometrium.
充足的子宫内膜生长是着床和妊娠的关键。在辅助生殖技术中,薄型子宫内膜与较低的妊娠率相关。一些冻融胚胎移植周期因子宫内膜生长不足而取消。
评估自体富血小板血浆(PRP)宫腔内输注治疗薄型子宫内膜的有效性。
2016年至2017年间,对72例因子宫内膜薄(<7mm)而有冻融胚胎移植周期取消史的患者进行了纳入研究的资格评估。12例患者因不同原因被排除,60例纳入患者以双盲方式随机分为PRP组或假导管组。所有参与者均接受激素替代疗法进行子宫内膜准备。因子宫内膜薄,在第11 - 12天进行PRP宫腔内输注或假导管操作,必要时48小时后重复。
两组在首次干预后48小时子宫内膜厚度均增加。由于子宫内膜扩张不足,所有参与者都需要第二次干预。第二次干预后,PRP组和假导管组的子宫内膜厚度分别为7.21±0.18mm和5.76±0.97mm。两组间差异有统计学意义(p<0.001)。PRP组所有患者均进行了胚胎移植,假导管组仅6例进行了胚胎移植。PRP组有12例报告化学妊娠,假导管组有2例。
根据本试验,PRP对难治性薄型子宫内膜患者的子宫内膜扩张有效。