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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.

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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