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自体富血小板血浆对接受冻融胚胎移植的反复种植失败患者妊娠结局的影响:一项随机对照试验。

The Effects of Autologous Platelet-Rich Plasma on Pregnancy Outcomes in Repeated Implantation Failure Patients Undergoing Frozen Embryo Transfer: A Randomized Controlled Trial.

作者信息

Nazari Leila, Salehpour Saghar, Hosseini Sedighe, Sheibani Samaneh, Hosseinirad Hossein

机构信息

Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Reprod Sci. 2022 Mar;29(3):993-1000. doi: 10.1007/s43032-021-00669-1. Epub 2021 Oct 14.

DOI:10.1007/s43032-021-00669-1
PMID:34651260
Abstract

Repeated implantation failure (RIF) is a disorder in which good-quality embryos fail to implant in the endometrium following several in vitro fertilization (IVF) cycles. This study aimed to evaluate the efficiency and safety of intrauterine infusion of platelet-rich plasma (PRP) in improvement of pregnancy outcomes in RIF patients undergoing frozen embryo transfer (FET). A total of 438 women with a history of RIF undergoing FET were assessed for eligibility to enter the study. Patients were randomly assigned to the intervention (PRP) and control groups. The intervention group received an intrauterine infusion of 0.5 ml PRP 48 h before embryo transfer while the control group received standard treatment. The rates of chemical and clinical pregnancy were defined as the primary outcome values. All women were followed up until the study endpoints that included the number of neonates born and pregnancy-related complications. Three hundred and ninety-three participants accomplished the study and their data were analyzed. The chemical pregnancy, clinical pregnancy, and live birth rates were higher in the PRP group than control group (p value: <0.0001; p value: <0.0001; p value: <0.0001 respectively). However, there were no significant differences between the two groups in terms of multiple pregnancies and pregnancy complications except for spontaneous abortion. The spontaneous abortion rate was significantly higher in the control group compared to the PRP group (p value = 0.0262). These results suggest that intrauterine infusion of PRP is an effective and safe route to improve pregnancy outcomes in RIF patients undergoing FET.

摘要

反复种植失败(RIF)是一种疾病,即在经历多个体外受精(IVF)周期后,优质胚胎未能在子宫内膜着床。本研究旨在评估宫腔内输注富血小板血浆(PRP)对接受冻融胚胎移植(FET)的RIF患者改善妊娠结局的有效性和安全性。共有438例有RIF病史且接受FET的女性接受了进入本研究的资格评估。患者被随机分配到干预组(PRP组)和对照组。干预组在胚胎移植前48小时接受0.5ml PRP宫腔内输注,而对照组接受标准治疗。将生化妊娠率和临床妊娠率定义为主要结局指标。所有女性均随访至研究终点,包括新生儿出生数量和妊娠相关并发症。393名参与者完成了研究并对其数据进行了分析。PRP组的生化妊娠率、临床妊娠率和活产率均高于对照组(p值分别为<0.0001;<0.0001;<0.0001)。然而,除自然流产外,两组在多胎妊娠和妊娠并发症方面无显著差异。与PRP组相比,对照组的自然流产率显著更高(p值=0.0262)。这些结果表明,宫腔内输注PRP是改善接受FET的RIF患者妊娠结局的一种有效且安全的途径。

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Arch Gynecol Obstet. 2025 May;311(5):1423-1433. doi: 10.1007/s00404-025-07983-y. Epub 2025 Mar 19.
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Is it justified to offer intrauterine infusion of autologous PRP in women with repeated implantation failure?对于反复种植失败的女性,给予自体富血小板血浆宫内输注是否合理?
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本文引用的文献

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Effects of autologous platelet-rich plasma on endometrial expansion in patients undergoing frozen-thawed embryo transfer: A double-blind RCT.自体富血小板血浆对接受冻融胚胎移植患者子宫内膜扩张的影响:一项双盲随机对照试验。
Int J Reprod Biomed. 2019 Jul 29;17(6):443-448. doi: 10.18502/ijrm.v17i6.4816. eCollection 2019 Jun.
2
Platelet-Rich Plasma and Stem Cells for Hair Growth: A Review of the Literature.富血小板血浆和干细胞在毛发生长中的应用:文献综述。
Aesthet Surg J. 2020 Mar 23;40(4):NP177-NP188. doi: 10.1093/asj/sjz146.
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Endometrial scratching prior to IVF; does it help and for whom? A systematic review and meta-analysis.
Comparative efficacy of intrauterine infusion treatments for recurrent implantation failure: a network meta-analysis of randomized controlled trials.
宫腔内灌注治疗复发性植入失败的比较疗效:一项随机对照试验的网状Meta分析
J Assist Reprod Genet. 2025 Apr;42(4):1177-1190. doi: 10.1007/s10815-025-03436-2. Epub 2025 Mar 4.
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The Efficiency of Introducing Intrauterine Infusion of Autologous Platelet-Rich Plasma versus Granulocyte Colony-Stimulating Factor in Repeated Implantation Failure Patients: An Unblinded Randomised Clinical Trial.宫腔内输注自体富血小板血浆与粒细胞集落刺激因子对反复种植失败患者的疗效比较:一项非盲随机临床试验
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Meta-analysis of intrauterine hCG perfusion efficacy in recurrent implantation failure as defined by ESHRE guidelines.ESHRE 指南定义的复发性着床失败患者宫腔内 hCG 灌注疗效的荟萃分析。
BMC Pregnancy Childbirth. 2024 Jul 9;24(1):468. doi: 10.1186/s12884-024-06662-1.
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Reprod Biol Endocrinol. 2024 Apr 16;22(1):44. doi: 10.1186/s12958-024-01221-x.
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Arch Gynecol Obstet. 2024 Jun;309(6):2323-2338. doi: 10.1007/s00404-024-07442-0. Epub 2024 Apr 8.
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The efficacy of intrauterine infusion of platelet rich plasma in women undergoing assisted reproduction: a systematic review and meta-analysis.宫腔内输注富血小板血浆治疗在接受辅助生殖技术治疗的妇女中的疗效:系统评价和荟萃分析。
BMC Pregnancy Childbirth. 2023 Dec 8;23(1):843. doi: 10.1186/s12884-023-06140-0.
体外受精前的子宫内膜搔刮术;它有帮助吗?对谁有帮助?一项系统评价和荟萃分析。
Hum Reprod Open. 2019 Jan 29;2019(1):hoy025. doi: 10.1093/hropen/hoy025. eCollection 2019.
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Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions.复发性植入失败——病因、诊断、治疗及未来方向的更新综述。
Reprod Biol Endocrinol. 2018 Dec 5;16(1):121. doi: 10.1186/s12958-018-0414-2.
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A Review of Platelet-Rich Plasma: History, Biology, Mechanism of Action, and Classification.富血小板血浆综述:历史、生物学、作用机制及分类
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Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization.自体富血小板血浆可促进子宫内膜生长并改善体外受精期间的妊娠结局。
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A comparison of biochemical pregnancy rates between women who underwent IVF and fertile controls who conceived spontaneously†.比较行体外受精(IVF)的女性与自然受孕的生育能力正常对照者的生化妊娠率。
Hum Reprod. 2015 Apr;30(4):783-8. doi: 10.1093/humrep/dev024. Epub 2015 Feb 11.
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Recurrent implantation failure: the role of the endometrium.反复种植失败:子宫内膜的作用
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