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卵巢内注射自体富血小板血浆改善卵巢反应不良患者的治疗方法:一项前后对照研究。

Intraovarian Injection of Autologous Platelet-Rich Plasma Improves Therapeutic Approaches in The Patients with Poor Ovarian Response: A Before-After Study.

作者信息

Navali Nazli, Sadeghi Leila, Farzadi Laya, Ghasemzadeh Aliyeh, Hamdi Kobra, Hakimi Parvin, Niknafs Behrouz

机构信息

Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Obstetrics and Gynecology, Alzahra Hospital, Tabriz University of Medical Sciences, Tabriz, Iran. Email:

出版信息

Int J Fertil Steril. 2022 Apr;16(2):90-94. doi: 10.22074/IJFS.2021.533576.1154. Epub 2022 May 8.

Abstract

BACKGROUND

Advanced age is associated with a decline in the natural oocytes, low oocyte yield, and also increases the assisted reproductive technology (ART) failure rate, and consequently resulted in a pregnancy rate decrease. Platelet-rich plasma (PRP) is one of the proposed therapeutic strategies for women with poor ovarian response (POR). Because of the autologous source of PRP, the lowest risks of disease transmission, immunogenic and allergic reactions have been expected. This study aimed to evaluate the single-dose intraovarian injection of autologous PRP in poor ovarian reserve.

MATERIALS AND METHODS

We conducted a clinical trial study in the Al-Zahra hospital and Milad Infertility Clinic, Tabriz, Iran (April and May, 2021). A total of thirty-five women with a POR and mean age 40.68 ± 0.34 enrolled in this study. After injection of autologous PRP into the ovaries, the number of oocytes, antral follicles, and level of estradiol, anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), luteal hormone (LH), FSH/LH ratio also were evaluated while, these parameters were evaluated before PRP administration.

RESULTS

At the 2-month follow-up, women treated with PRP showed a significant elevation in the number of oocytes (3.68 ± 0.24, P=0.0043) and embryos (3.17 ± 0.14, P=0.0001), as well as in the estradiol levels (404.1 ± 16.76 vs. 237.7 ± 13.14, P=0.0003).

CONCLUSION

Single PRP injection is effective and might be a promising therapeutic approach in the patients with POR to conceive with their own oocytes, although further evidence is required to assess the influence of PRP on the live birth rate.

摘要

背景

高龄与自然卵母细胞数量减少、卵母细胞产量低相关,还会增加辅助生殖技术(ART)失败率,进而导致妊娠率下降。富血小板血浆(PRP)是针对卵巢反应不良(POR)女性提出的治疗策略之一。由于PRP的自体来源,预计其疾病传播、免疫原性和过敏反应风险最低。本研究旨在评估单剂量自体PRP卵巢内注射治疗卵巢储备功能低下的效果。

材料与方法

我们于2021年4月和5月在伊朗大不里士的阿尔扎赫拉医院和米拉德不孕不育诊所进行了一项临床试验研究。共有35名POR女性,平均年龄40.68±0.34岁纳入本研究。向卵巢内注射自体PRP后,评估卵母细胞数量、窦卵泡数量、雌二醇水平、抗苗勒管激素(AMH)、促卵泡激素(FSH)、黄体生成素(LH)、FSH/LH比值,同时在注射PRP前评估这些参数。

结果

在2个月的随访中,接受PRP治疗的女性卵母细胞数量(3.68±0.24,P=0.0043)、胚胎数量(3.17±0.14,P=0.0001)以及雌二醇水平(404.1±16.76对237.7±13.14,P=0.0003)均显著升高。

结论

单次PRP注射是有效的,对于POR患者使用自身卵母细胞受孕可能是一种有前景的治疗方法,尽管需要进一步证据来评估PRP对活产率的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d62b/9108296/314fd69314ca/Int-J-Fertil-Steril-16-90-g01.jpg

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