富含血小板血浆在既往着床失败患者中的应用价值：系统评价和荟萃分析。

The value of platelet-rich plasma in women with previous implantation failure: a systematic review and meta-analysis.

机构信息

Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.

Department of Obstetrics and Gynecology, Beni-Suef University, Beni-Suef, Egypt.

出版信息

J Assist Reprod Genet. 2023 May;40(5):969-983. doi: 10.1007/s10815-023-02781-4. Epub 2023 Apr 3.

OBJECTIVE

To assess the value of intrauterine PRP to improve IVF outcome in women with previous implantation failure.

METHODS

Screening of Pubmed, Web of Science, and other databases from inception to August 2022 using the keywords related to "platelet-rich plasma" OR "PRP" AND "IVF" "implantation failure." Twenty-nine studies (3308 participants) were included in our analysis, 13 were RCTs, 6 were prospective cohorts, 4 were prospective single arm, and 6 were retrospective analyses. Extracted data included settings of the study, study type, sample size, participants' characteristics, route, volume, timing of PRP administration, and outcome parameters.

RESULTS

Implantation rate was reported in 6 RCTs (886 participants) and 4 non-RCTs (732 participants). The odds ratio (OR) effect estimate was 2.62 and 2.06, with 95% CI of 1.83, 3.76, and 1.03-4.11, respectively. Endometrial thickness was compared in 4 RCTs (307 participants) and 9 non-RCTs (675 participants), which showed a mean difference of 0.93 and 1.16, with 0.59-1.27 and 0.68-1.65 95% CI, respectively.

CONCLUSION

PRP administration improves implantation, clinical pregnancy, chemical pregnancy, ongoing pregnancy, live birth rates, and endometrial thickness in women with previous implantation failure.

目的

评估宫腔内富血小板血浆（PRP）对改善既往着床失败患者体外受精（IVF）结局的价值。

方法

检索 Pubmed、Web of Science 及其他数据库，检索词包括“platelet-rich plasma”或“PRP”和“IVF”“implantation failure”，时间限定为建库至 2022 年 8 月。共纳入 29 项研究（3308 例参与者），其中 13 项为随机对照试验（RCT），6 项为前瞻性队列研究，4 项为前瞻性单臂研究，6 项为回顾性分析。提取的数据包括研究设置、研究类型、样本量、参与者特征、PRP 给药途径、剂量、时间，以及结局参数。

结果

6 项 RCT（886 例参与者）和 4 项非 RCT（732 例参与者）报道了着床率。优势比（OR）效应估计值分别为 2.62 和 2.06，95%可信区间（CI）为 1.83，3.76 和 1.03-4.11。4 项 RCT（307 例参与者）和 9 项非 RCT（675 例参与者）比较了子宫内膜厚度，平均差分别为 0.93 和 1.16，95%CI 分别为 0.59-1.27 和 0.68-1.65。