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宫腔内输注自体富含血小板血浆可以成为不明原因复发性种植失败患者的一种有效治疗方法。

Intrauterine infusion of autologous platelet rich plasma can be an efficient treatment for patients with unexplained recurrent implantation failure.

机构信息

Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.

Department of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, Tehran, Iran.

出版信息

Sci Rep. 2024 Oct 29;14(1):26009. doi: 10.1038/s41598-024-77578-1.

Abstract

The studies posits that there is not sufficient evidence to support the use of intrauterine platelet-rich plasma (PRP) infusion in patients with recurrent implantation failure (RIF). This study aims to investigate the effects of infusion of PRP on patients with unexplained-RIF in fresh and frozen embryo transfer (ET) cycles. A total of 80 participants were included in this study. The participants were randomly assigned to one of two groups with and without PRP infusion. Each of the PRP and control groups were also divided into fresh and frozen ET subgroups. ET outcomes were compared between groups. Clinical pregnancy rate was significantly higher in Frozen ET in PRP group than other subgroups (p < 0.0001). Miscarriage rate were significantly lower in PRP group than control group. Pregnancy complications and preterm labor were significantly higher in PRP group than control group (p < 0.0001). Live birth and healthy baby rate were significantly higher in PRP group than control group (p < 0.0001). The intrauterine infusion of 0.8-1 ml of PRP 48 h before blastocyst ET at fresh and frozen cycles can be an efficient treatment option for u-RIF patients. Also, results indicated that the clinical pregnancy rate was equal to the live birth rate at fresh ET cycles, whereas the live birth rate was lower than the clinical pregnancy rate at frozen ET cycles. Therefore, considering the superiority of fresh cycles over freeze cycles, the infusion of PRP into the uterus of patients with RIF is recommended to be done at fresh ET cycles.Trial registration: NCT, NCT03996837. Registered 25/06/2019. Retrospectively registered, http://www.clinicaltrial.gov/ NCT03996837.

摘要

该研究提出,没有足够的证据支持在复发性着床失败(RIF)患者中使用宫内富含血小板的血浆(PRP)输注。本研究旨在探讨 PRP 输注对新鲜和冷冻胚胎移植(ET)周期中不明原因 RIF 患者的影响。共有 80 名参与者纳入本研究。参与者被随机分配到 PRP 输注组和无 PRP 输注组。PRP 组和对照组每组又分为新鲜和冷冻 ET 亚组。比较组间 ET 结局。PRP 组冷冻 ET 的临床妊娠率明显高于其他亚组(p<0.0001)。PRP 组的流产率明显低于对照组。PRP 组的妊娠并发症和早产率明显高于对照组(p<0.0001)。PRP 组的活产率和健康婴儿率明显高于对照组(p<0.0001)。在新鲜和冷冻周期中,在囊胚 ET 前 48 小时宫内输注 0.8-1ml 的 PRP 可以作为 u-RIF 患者的有效治疗选择。此外,结果表明,新鲜 ET 周期的临床妊娠率与活产率相等,而冷冻 ET 周期的活产率低于临床妊娠率。因此,考虑到新鲜周期优于冷冻周期,建议在新鲜 ET 周期中向 RIF 患者的子宫内输注 PRP。试验注册:NCT,NCT03996837。注册于 2019 年 6 月 25 日。回顾性注册,http://www.clinicaltrial.gov/NCT03996837。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7d0/11522411/34ea527e6bc2/41598_2024_77578_Fig1_HTML.jpg

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