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富血小板血浆宫腔内输注作为辅助生殖技术(ART)治疗反复种植失败(RIF):一项系统评价和荟萃分析

Platelet-Rich Plasma Intrauterine Infusion as Assisted Reproduction Technology (ART) to Combat Repeated Implantation Failure (RIF): A Systematic Review and Meta-Analysis.

作者信息

Huang Chunling, Ye Xiaohui, Ye Lifang, Lu Lunyuan, Liu Fengxiang

机构信息

Center for Reproductive Medicine, Ganzhou People's Hospital, Ganzhou, 341000, China.

出版信息

Iran J Public Health. 2023 Aug;52(8):1542-1554. doi: 10.18502/ijph.v52i8.13394.

Abstract

BACKGROUND

Repeated implantation failure (RIF) is considered one of the major challenges facing clinician in assisted reproduction technologies (ART) despite the significant advances that have been made in this field. Platelet rich plasma (PRP), also known as autologous conditioned plasma, is a protein concentrate with anti-inflammatory and pro-regenerative characteristics. The use of PRP in women undergoing ART has been studied in the past, with varying degrees of success. The goal of this trial was to see if injecting PRP into the uterus improves pregnancy outcomes in women receiving ART.

METHODS

PubMed, Embase, Scopus, Web of Science, and the Cochrane Database of Clinical Trials were among the databases searched (CENTRAL), from 2015 to 2021. The pooled estimates were calculated using a meta-analysis with a random-effects model. There were 14 studies with a total of 1081 individuals (549 cases and 532 controls).

RESULTS

There was no difference in miscarriage rates between women who got PRP and those who received placebo (). Chemical pregnancy (), clinical pregnancy ), and implantation rate () were all significantly higher in women. Endometrial thickness increased in women who got PRP vs women who received placebo after the intervention ().

CONCLUSION

PRP may be an alternate therapeutic approach for individuals with thin endometrium and RIF, according to the findings of this comprehensive study. To determine the subgroup that would benefit the most from PRP, more prospective, big, and high-quality randomized controlled trials (RCTs) are needed.

摘要

背景

尽管辅助生殖技术(ART)领域已取得重大进展,但反复种植失败(RIF)仍被认为是临床医生面临的主要挑战之一。富血小板血浆(PRP),也称为自体条件血浆,是一种具有抗炎和促再生特性的蛋白质浓缩物。过去已经对接受ART的女性使用PRP进行了研究,取得了不同程度的成功。本试验的目的是观察向子宫内注射PRP是否能改善接受ART的女性的妊娠结局。

方法

检索了2015年至2021年期间的PubMed、Embase、Scopus、Web of Science和Cochrane临床试验数据库(CENTRAL)。使用随机效应模型的荟萃分析计算合并估计值。共有14项研究,总计1081人(549例病例和532例对照)。

结果

接受PRP的女性与接受安慰剂的女性流产率没有差异()。接受PRP的女性化学妊娠()、临床妊娠()和着床率()均显著更高。干预后,接受PRP的女性子宫内膜厚度相对于接受安慰剂的女性有所增加()。

结论

根据这项综合研究的结果,PRP可能是子宫内膜薄和RIF患者的一种替代治疗方法。需要更多前瞻性、大型和高质量的随机对照试验(RCT)来确定最能从PRP中获益的亚组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/37f6/10512147/7c32b66af17d/IJPH-52-1542-g001.jpg

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