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富含生长因子的血浆(PRGF-Endoret)在难治性病例中增强辅助生殖技术疗效的潜力。

Potential of Plasma Rich in Growth Factors (PRGF-Endoret) to Enhance the Efficacy of Assisted Reproductive Techniques in Refractory Cases.

作者信息

Agirregoikoa Jon Ander, de Pablo Jose Luis, de la Fuente Maria, Anitua Eduardo

机构信息

Embryology Laboratory, Clínica ART, Vitoria, ESP.

Regenerative Medicine Laboratory, Biotechnology Institute ImasD, Vitoria, ESP.

出版信息

Cureus. 2022 Jul 6;14(7):e26623. doi: 10.7759/cureus.26623. eCollection 2022 Jul.

Abstract

AIM

Nowadays, infertility problems affect a high percentage of couples. This study aimed to evaluate the effect of plasma rich in growth factors (PRGF-Endoret, hereafter PRGF) as a promising coadjuvant therapy in assisted reproductive techniques and its possible role in implantation and pregnancy rates. This retrospective study included 36 PRGF cycles in 27 women with one of the following reproductive disorders: recurrent implantation failure (n = 16), repeated abortion (n = 8), and thin endometrium (n = 3).

METHODS

PRGF was obtained from each patient and administered as three consecutive intrauterine instillations. The endometrial thickness was measured after each PRGF infusion and a good-quality embryo transfer was performed for every patient. Endometrial thickness, biochemical pregnancy, and miscarriage rate were the primary measured outcomes.

RESULTS

PRGF increased the endometrial growth respecting the initial thickness in all cases. The biochemical pregnancy rate determined as positive beta-human chorionic gonadotropin (β-hCG) was 59%, considering the total number of patients; the ongoing pregnancy percentage was 48%. PRGF application day was relevant with a significant probability of achieving pregnancy (p < 0.01) when the first PRGF infusion was carried out beyond 6.5 days after the first day of the woman's cycle and the second one beyond 9.5 days of the menstrual cycle.

CONCLUSIONS

Intrauterine autologous PRGF infusion is a safe, easily accessible, and inexpensive therapy that could collaborate in fertility treatments by optimizing the endometrium for implantation and thus favoring the crosstalk between the embryo and the uterus improving the embryo-maternal dialogue.

摘要

目的

如今,不孕问题影响着很大比例的夫妇。本研究旨在评估富含生长因子的血浆(PRGF-Endoret,以下简称PRGF)作为辅助生殖技术中一种有前景的辅助治疗方法的效果及其在着床率和妊娠率方面可能发挥的作用。这项回顾性研究纳入了27名患有以下生殖疾病之一的女性的36个PRGF周期:反复着床失败(n = 16)、反复流产(n = 8)和子宫内膜薄(n = 3)。

方法

从每位患者获取PRGF,并连续进行三次子宫内灌注。每次PRGF灌注后测量子宫内膜厚度,为每位患者进行优质胚胎移植。子宫内膜厚度、生化妊娠和流产率是主要测量结果。

结果

在所有病例中,PRGF均使子宫内膜相对于初始厚度有所增长。以β-人绒毛膜促性腺激素(β-hCG)阳性确定的生化妊娠率,考虑患者总数为59%;持续妊娠率为48%。当第一次PRGF灌注在女性月经周期第一天后超过6.5天进行,第二次灌注在月经周期第9.5天后进行时,PRGF应用日与实现妊娠的显著概率相关(p < 0.01)。

结论

子宫内自体PRGF灌注是一种安全、易于获取且廉价的治疗方法,可通过优化子宫内膜以利于着床,从而促进胚胎与子宫之间的相互作用,改善胚胎与母体的对话,在生育治疗中发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/124e/9356660/5b1eb812d344/cureus-0014-00000026623-i01.jpg

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