卵巢内自体富含血小板血浆输注治疗卵巢储备功能不良患者的前后研究。

Intra-ovarian infusion of autologous platelet-rich plasma in women with poor ovarian reserve: A before and after study.

机构信息

Department of Obstetrics and Gynecology, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran.

Department of Hematology and Laboratory Sciences, School of Paramedical Sciences, Kerman University of Medical Sciences and Health Services, Kerman, Iran; Pathology and Stem Cell Research Center, Kerman University of Medical Sciences and Health Services, Kerman, Iran.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2023 Jan;280:60-63. doi: 10.1016/j.ejogrb.2022.11.001. Epub 2022 Nov 4.

DOI:10.1016/j.ejogrb.2022.11.001

PMID:36403398

Abstract

OBJECTIVE

Female ovarian reserve progressively declines with increasing age. Intraovarian injection of platelet-rich plasma (PRP) seems to be an alternative treatment to increase fertility in women. Therefore, this study aimed to evaluate the effect of intra-ovarian infusion of PRP in treating women with poor ovarian reserve.

MATERIALS AND METHODS

In this before-and-after study, 22 infertile women with a poor ovarian reserve who underwent in vitro fertilization with the GnRH antagonist protocol were enrolled. After the oocyte retrieval undergoing vaginal ultrasound guide, PRP was injected into the ovary with a puncture needle under general anesthesia. Finally, the levels of anti-Müllerian hormone (AMH) and antral follicle counts (AFCs) were compared in all participants before and three months after the PRP injection.

RESULTS

Our findings showed that AMH significantly increased after the intra-ovarian infusion of PRP (P < 0.001) in these women, while no significant changes were observed in AFC (P = 0.140) at the end of the study. In addition, logistic regression indicated that body mass index (BMI) and maternal age had no significant effect on ovarian response to PRP injection. However, the duration of infertility > 5 years was associated with a 20-fold increase in the probability of AFC < 7 in women with poor ovarian reserve.

CONCLUSIONS

PRP can increase the chance of fertility in women with poor ovarian reserve by significantly increasing AMH levels.

摘要

目的

女性卵巢储备功能随年龄增长而逐渐下降。卵巢内注射富含血小板的血浆（PRP）似乎是一种增加女性生育能力的替代治疗方法。因此，本研究旨在评估 PRP 卵巢内注射治疗卵巢储备功能不良妇女的效果。

材料和方法

在这项前后对照研究中，我们纳入了 22 名接受 GnRH 拮抗剂方案体外受精的卵巢储备功能不良的不孕妇女。在阴道超声引导下取卵后，在全身麻醉下用穿刺针将 PRP 注入卵巢。最后，比较所有参与者在 PRP 注射前和注射后三个月的抗苗勒管激素（AMH）和窦卵泡计数（AFC）水平。

结果

我们的研究结果表明，PRP 卵巢内注射后，这些妇女的 AMH 水平显著升高（P<0.001），而 AFC 在研究结束时无显著变化（P=0.140）。此外，逻辑回归表明，体重指数（BMI）和产妇年龄对 PRP 注射对卵巢的反应没有显著影响。然而，不孕持续时间>5 年与卵巢储备功能不良妇女 AFC<7 的概率增加 20 倍相关。