Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Department of Obstetrics and Gynecology, Xiehe Hospital, Tongji Medical University, Wuhan, China.
J Obstet Gynaecol Res. 2021 Nov;47(11):3883-3894. doi: 10.1111/jog.14964. Epub 2021 Sep 5.
To evaluate the efficacy and safety of autologous platelet-rich fibrin (PRF) for the treatment of infertility with intrauterine adhesions.
Forty patients who suffered from infertility with intrauterine adhesions (IUAs) were enrolled in this prospective trial from October 2018 to December 2019. They were randomly divided into a PRF group and a control group. Both groups underwent transcervical resection of adhesions (TCRA) during the follicular phase. PRF group: PRF prepared from autologous venous blood was placed in the uterine cavity after TCRA and after the first menstrual re-fluid; control group: no PRF insertion. After the second menstrual re-fluid, both groups underwent hysteroscopy to reevaluate adhesion severity. Pregnancy rate, intrauterine adhesion score, menstrual volume and duration, and endometrial thickness were assessed and adverse events were recorded.
(1) PRF group pregnancy rate was significantly higher than the control group (55.0% vs. 20.0%). Mean follow-up time was (17.63 ± 2.33) months. All patients fell pregnant naturally. Four (PRF) and one (control) patients delivered live births without placental complications. (2) Intrauterine adhesion scores decreased compared with treatment-before. (3) In the pictorial blood loss assessment chart, score and menstrual duration during the 3rd menstrual cycle showed significant improvements for both groups. (4) Endometrial thickness also showed an increasing trend, and subendometrial bloodflow improved. (5) No treatment-related serious adverse events were noted.
Placing PRF into the uterine cavity of infertility patients with IUAs following TCRA is a safe and effective therapeutic method.
评估自体富血小板纤维蛋白（PRF）治疗宫腔粘连（IUAs）所致不孕的疗效和安全性。
本前瞻性试验纳入了 2018 年 10 月至 2019 年 12 月期间 40 例因 IUAs 导致不孕的患者。他们被随机分为 PRF 组和对照组。两组均在卵泡期行经宫颈粘连切除术（TCRA）。PRF 组：TCRA 后和首次月经再出血后将自体静脉血制备的 PRF 置于宫腔内；对照组：不插入 PRF。第二次月经再出血后，两组均行宫腔镜检查重新评估粘连严重程度。评估妊娠率、宫腔粘连评分、月经量和持续时间以及子宫内膜厚度，并记录不良反应。
（1）PRF 组妊娠率明显高于对照组（55.0% vs. 20.0%）。平均随访时间为（17.63 ± 2.33）个月。所有患者均自然受孕。4 例（PRF 组）和 1 例（对照组）患者分娩活产儿，无胎盘并发症。（2）宫腔粘连评分较治疗前降低。（3）在图像出血量评估图表中，两组第 3 个月经周期的评分和月经持续时间均有显著改善。（4）子宫内膜厚度也呈增加趋势，子宫内膜下血流改善。（5）未观察到与治疗相关的严重不良事件。
在 TCRA 后将 PRF 置于 IUAs 不孕患者的宫腔内是一种安全有效的治疗方法。
