Fattahi Meybodi Neda, Eftekhar Maryam, Gandom Behnaz
Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Int J Reprod Biomed. 2024 Feb 23;22(1):9-16. doi: 10.18502/ijrm.v22i1.15236. eCollection 2024 Jan.
Finding the most effective way to improve implantation rate in women who are receiving assisted reproductive technology treatment is still a challenge.
This study aimed to assess the pregnancy outcomes of intrauterine platelet-rich plasma (PRP) therapy in women with a history of at least 2 implantation failures.
In this retrospective cohort study, data of 852 women who were candidates for frozen-thawed embryo transfer was extracted from their medical records from April 2017 to September 2021 at Yazd Reproductive Sciences Institute, Yazd, Iran. Of these, 432 received intrauterine PRP treatment 48 hr before transfer (PRP group), and the results of the pregnancy outcomes compared with 420 of the control group who did not receive the treatment before transfer.
Pregnancy outcomes, including chemical, clinical, ongoing pregnancy, and live birth rate were statistically significant in the PRP group (p 0.001). However, when categorized according to the implantation history, this significant improvement in all 4 was only seen in women with at least 2 prior implantation failures. In women with a history of only one implantation failure, PRP therapy significantly improved the ongoing pregnancy and live birth rate (19.5%, p = 0.04). Also, in women who received donor eggs and had repeated implantation failure, PRP improved pregnancy outcomes clinically but not statistically (p = 0.15).
PRP seems to be effective in improving the pregnancy rate in women with a history of 2 or more implantation failures and also shows an increase in the live birth rate in women with only one implantation failure.
找到提高接受辅助生殖技术治疗女性着床率的最有效方法仍是一项挑战。
本研究旨在评估宫腔内注射富血小板血浆（PRP）疗法对有至少2次着床失败史女性的妊娠结局。
在这项回顾性队列研究中，从伊朗亚兹德生殖科学研究所2017年4月至2021年9月的医疗记录中提取了852名冻融胚胎移植候选女性的数据。其中，432名在移植前48小时接受了宫腔内PRP治疗（PRP组），并将妊娠结局结果与移植前未接受治疗的420名对照组女性进行比较。
PRP组的妊娠结局，包括生化妊娠、临床妊娠、持续妊娠和活产率具有统计学意义（p < 0.001）。然而，根据着床史分类时，所有这4项的显著改善仅见于有至少2次既往着床失败的女性。在只有1次着床失败史的女性中，PRP疗法显著提高了持续妊娠和活产率（19.5%，p = 0.04）。此外，在接受供体卵子且反复着床失败的女性中，PRP在临床上改善了妊娠结局，但无统计学意义（p = 0.15）。
PRP似乎对提高有2次或更多次着床失败史女性的妊娠率有效，并且在只有1次着床失败史的女性中也显示活产率有所提高。
