Liu Xiao-Hui, He Li-Xia, Li Man, Tian Zheng-Ping, Qin An-Qi, Yao Jun
Department of Reproductive Medical Center, The Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China.
Arch Gynecol Obstet. 2025 May;311(5):1423-1433. doi: 10.1007/s00404-025-07983-y. Epub 2025 Mar 19.
To explore the effects of autologous platelet-rich plasma (PRP) intrauterine perfusion on clinical outcomes in recurrent implantation failure (RIF) patients with non-thin endometrium undergoing frozen-thawed embryo transfer (FET), and the effects of PRP used at different times before FET on clinical outcomes.
A total of 160 RIF patients with non-thin endometrium undergoing FET were retrospectively analyzed. Among them, 82 patients received PRP intrauterine perfusion at 24-72 h before FET (PRP group), and 78 patients did not (non-PRP group). In PRP group, 59 patients underwent PRP at 24-48 h before FET (≥ 24 to ≤ 48 h group), and 23 patients was at 48-72 h (> 48 to ≤ 72 h group). The clinical outcomes were compared, including β-hCG positive rate, clinical pregnancy rate, embryo implantation rate, abortion rate, ectopic pregnancy rate, live birth rate and the incidence of adverse events.
The clinical pregnancy rate, embryo implantation rate and live birth rate in PRP group were significantly higher than those in non-PRP group (P < 0.05), and there were no statistical differences in β-hCG rate, abortion rate and ectopic pregnancy rate between the two groups (P > 0.05). Meanwhile, there was no adverse events occurred in PRP group. However, the C-type endometrium rate in PRP group was observably higher on FET day (Χ = 8.309, P = 0.004), though there was no statistical difference in endometrial thickness (P > 0.05). The multiple logistics regression analysis showed that PRP intrauterine perfusion are closely related with clinical pregnancy and live birth in RIF patients with non-thin endometrium (OR: 2.379, 95% CI 1.137-4.977, P = 0.021; OR: 2.107, 95% CI 1.006-4.412, P = 0.048). Moreover, we found no significant difference in clinical outcomes between the two groups of PRP intrauterine perfusion at ≥ 24 to ≤ 48 h and > 48 to ≤ 72 h before FET (P > 0.05), except for β-hCG positive rate.
PRP intrauterine perfusion can safely and effectively improve the clinical pregnancy rate, implantation rate and live birth rate in RIF patients with non-thin endometrium possibly by increasing the C-type endometrium rate on FET day. In addition, PRP intrauterine perfusion at different times of 24-72 h before FET does not affect the clinical outcomes, which will be helpful to guide clinical work flexibly.
探讨自体富血小板血浆（PRP）宫腔灌注对非薄型子宫内膜反复种植失败（RIF）患者冻融胚胎移植（FET）临床结局的影响，以及FET前不同时间应用PRP对临床结局的影响。
回顾性分析160例接受FET的非薄型子宫内膜RIF患者。其中，82例患者在FET前24 - 72小时接受PRP宫腔灌注（PRP组），78例患者未接受（非PRP组）。在PRP组中，59例患者在FET前24 - 48小时接受PRP（≥24至≤48小时组），23例患者在48 - 72小时接受（>48至≤72小时组）。比较两组的临床结局，包括β - hCG阳性率、临床妊娠率、胚胎着床率、流产率、异位妊娠率、活产率和不良事件发生率。
PRP组的临床妊娠率、胚胎着床率和活产率显著高于非PRP组（P < 0.05），两组间β - hCG阳性率、流产率和异位妊娠率无统计学差异（P > 0.05）。同时，PRP组未发生不良事件。然而，FET日PRP组的C型子宫内膜率明显更高（Χ = 8.309，P = 0.004），尽管子宫内膜厚度无统计学差异（P > 0.05）。多元逻辑回归分析显示，PRP宫腔灌注与非薄型子宫内膜RIF患者的临床妊娠和活产密切相关（OR：2.379，95%CI 1.137 - 4.977，P = 0.021；OR：2.107，95%CI 1.006 - 4.412，P = 0.048）。此外，我们发现FET前≥24至≤48小时和>48至≤72小时两组PRP宫腔灌注的临床结局除β - hCG阳性率外无显著差异（P > 0.05）。
PRP宫腔灌注可安全有效地提高非薄型子宫内膜RIF患者的临床妊娠率、着床率和活产率，可能是通过增加FET日的C型子宫内膜率实现的。此外，FET前24 - 72小时不同时间应用PRP不影响临床结局，这将有助于灵活指导临床工作。
