Pacu Irina, Zygouropoulos Nikolaos, Dimitriu Mihai, Rosu George, Ionescu Cringu A
Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Obstetrics and Gynecology, 'Sf. Pantelimon' Emergency Clinical Hospital, 021623 Bucharest, Romania.
Exp Ther Med. 2021 Dec;22(6):1412. doi: 10.3892/etm.2021.10848. Epub 2021 Oct 7.
Couple infertility is a pathology with an absolute number of cases growing markedly over the last decade in connection mainly with the increased age of couples wishing to conceive. Platelet-rich plasma (PRP) is an alternative treatment used for several years for experimental purposes. Yet, this method is not yet defined as a standard therapeutic option in the infertility protocol for poor responders in assisted human reproduction procedures. Thus, the present study is a retrospective study conducted between February 2019 and February 2020 to evaluate the effect of ovarian PRP injection in patients with a poor ovarian response (POR) to ovarian stimulation. Women (n=20; age 31-44 years) diagnosed with POR based on the European Society of Human Reproduction and Embryology criteria underwent ovarian injection with autologous PRP injection. Markers of ovarian reserve before, during the following two menstrual cycles, and at six months after treatment were followed as well as stimulation and fertilisation parameters before and post-treatment. PRP treatment resulted in increased antral follicle count and serum anti-Mullerian hormone, while levels of serum follicle-stimulating hormone and luteinising hormone were decreased. These changes were more pronounced during the 2nd menstrual cycle following treatment. By six months following the injection, their values return to pre-treatment levels and any small differences were not considered statistically significant. The average dose of gonadotropin used and duration remained statistically unchanged, but a significant increase in estradiol achieved by the day of the human chorionic gonadotropin trigger day was achieved. The cancellation rate decreased following PRP treatment while the number of collected oocytes, number of oocytes in metaphase II rose. The number of embryos (of A and B quality) resulting also increased but fell short of the significance level set (α=0.073). Following the PRP injection, two singleton pregnancies were achieved, resulting in live births at term without complications during pregnancy. Another pregnancy was achieved spontaneously 45 months following the PRP and a failed assisted human reproduction procedure. Although the group included a small number of women, the results indicate the potential benefits of an ovarian autologous PRP injection in women with POR. Positive results appear to be short-term for 2-6 months after the procedure.
夫妻不孕是一种病理状况，在过去十年中，其病例绝对数量显著增加，主要与希望受孕的夫妻年龄增大有关。富血小板血浆（PRP）作为一种替代疗法已用于实验数年。然而，在辅助人类生殖程序中，对于反应不良者的不孕治疗方案中，该方法尚未被定义为标准治疗选择。因此，本研究是一项在2019年2月至2020年2月期间进行的回顾性研究，旨在评估卵巢注射PRP对卵巢刺激反应不良（POR）患者的影响。根据欧洲人类生殖与胚胎学会标准诊断为POR的女性（n = 20；年龄31 - 44岁）接受了自体PRP卵巢注射。在治疗前、随后两个月经周期期间以及治疗后六个月跟踪卵巢储备标志物，以及治疗前后的刺激和受精参数。PRP治疗导致窦卵泡计数增加和血清抗苗勒管激素升高，而血清促卵泡生成素和黄体生成素水平降低。这些变化在治疗后的第二个月经周期更为明显。注射后六个月，其值恢复到治疗前水平，任何微小差异均未被认为具有统计学意义。使用的促性腺激素平均剂量和持续时间在统计学上保持不变，但在人绒毛膜促性腺激素触发日当天，雌二醇显著增加。PRP治疗后取消率降低，同时采集的卵母细胞数量、处于中期II的卵母细胞数量增加。产生的胚胎（A和B级质量）数量也增加，但未达到设定的显著性水平（α = 0.073）。PRP注射后，实现了两次单胎妊娠，足月分娩且孕期无并发症。在PRP注射和一次失败的辅助人类生殖程序后45个月，又自然受孕。尽管该组女性数量较少，但结果表明自体PRP卵巢注射对POR女性具有潜在益处。积极结果似乎在该程序后2至6个月为短期效应。
