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卵巢内注射富血小板血浆(PRP)似乎对体外受精(IVF)预后较差的患者有益;然而,与对照组相比,未证实有显著益处。

Intraovarian platelet-rich plasma (PRP) infusion appeared to benefit low prognosis IVF patients; however, when compared to controls, no significant benefit could be confirmed.

作者信息

Rubin Sarah C, Noruzi Kaleb, Chen Emily, Greene Alexis, Keltz Martin

机构信息

New York Medical College, 35 Sunshine Cottage Road, Valhalla, NY, 10595, USA.

WestMed Reproductive Services, Purchase, NY, 10595, USA.

出版信息

J Assist Reprod Genet. 2025 Jun 2. doi: 10.1007/s10815-025-03530-5.

DOI:10.1007/s10815-025-03530-5
PMID:40455357
Abstract

PURPOSE

To assess whether in-office intraovarian PRP injections among patients with a history of a low euploid embryo yield following freeze-all PGT-A IVF cycle improves transferable embryo yield when compared to controls.

MATERIALS AND METHODS

A retrospective case-control study, between March 2022 and December 2024 where all poor outcome patients who underwent in-office intraovarian PRP injection prior to a repeat freeze-all PGT-A IVF cycle were compared to controls with no intervention between cycles. The primary outcome was transferable embryo yield. Secondary outcomes included: blastocyst yield, aneuploidy rate, and euploid yield.

RESULTS

Thirty-two patients met the inclusion criteria and were compared to 309 controls. Mean age for the PRP and control group were 38.3 ± 3.1 and 38.4 ± 3.7 (p = 0.91) respectively. Mean AMH for the PRP group was 1.6 ± 1.1 ng/mL as compared to 1.5 ± 1.0 ng/mL (p = 0.34). Following PRP the blastocyst, euploid and transferable embryo yield increased; however, when compared to controls, there were no differences in IVF outcomes. For patients with an AMH ≥ 1, the euploid yield and transferable embryo yield increased by fivefold; however, there was no difference when compared to the control. For patients with an AMH < 1, there were no differences in euploid or transferable embryo yield following PRP.

CONCLUSION

Although there was an improvement in transferable embryos yielded following PRP, no difference was observed compared to the control group, as the control with a poor initial cycle experienced regression to the mean which may also be a source of bias in the PRP group.

摘要

目的

评估在冻存全部胚胎的植入前遗传学检测-非整倍体(PGT-A)体外受精(IVF)周期后,既往整倍体胚胎产出率低的患者进行门诊卵巢内注射富血小板血浆(PRP)与对照组相比,是否能提高可移植胚胎的产出率。

材料与方法

一项回顾性病例对照研究,时间跨度为2022年3月至2024年12月,将所有在重复冻存全部胚胎的PGT-A IVF周期前接受门诊卵巢内PRP注射的不良结局患者与周期之间未进行干预的对照组进行比较。主要结局是可移植胚胎产出率。次要结局包括:囊胚产出率、非整倍体率和整倍体产出率。

结果

32例患者符合纳入标准,并与309例对照组进行比较。PRP组和对照组的平均年龄分别为38.3±3.1岁和38.4±3.7岁(p = 0.91)。PRP组的平均抗缪勒管激素(AMH)为1.6±1.1 ng/mL,而对照组为1.5±1.0 ng/mL(p = 0.34)。PRP注射后,囊胚、整倍体和可移植胚胎的产出率增加;然而,与对照组相比,IVF结局没有差异。对于AMH≥1的患者,整倍体产出率和可移植胚胎产出率增加了五倍;然而,与对照组相比没有差异。对于AMH<1的患者,PRP注射后整倍体或可移植胚胎产出率没有差异。

结论

尽管PRP注射后可移植胚胎产出率有所提高,但与对照组相比未观察到差异,因为初始周期不良的对照组出现了均值回归,这也可能是PRP组的一个偏倚来源。

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本文引用的文献

1
Intraovarian platelet-rich plasma injection significantly improves blastocyst yield and quality in IVF patients.卵巢内注射富含血小板血浆可显著提高体外受精患者的囊胚产量和质量。
Sci Rep. 2025 Jan 8;15(1):1301. doi: 10.1038/s41598-024-82630-1.
2
Intraovarian Platelet-Rich Plasma Administration for Anovulatory Infertility: Preliminary Findings of a Prospective Cohort Study.卵巢内注射富含血小板血浆治疗无排卵性不孕症:一项前瞻性队列研究的初步结果
J Clin Med. 2024 Sep 6;13(17):5292. doi: 10.3390/jcm13175292.
3
Intraovarian platelet-rich plasma injection and IVF outcomes in patients with poor ovarian response: a double-blind randomized controlled trial.
卵巢内富含血小板血浆注射联合 IVF 治疗卵巢反应不良患者的结局:一项双盲随机对照试验。
Hum Reprod. 2024 Apr 3;39(4):760-769. doi: 10.1093/humrep/deae038.
4
Intraovarian Platelet-Rich Plasma Injections: Safety and Thoughts on Efficacy Based on a Single Centre Experience With 469 Women.卵巢内注射富含血小板血浆:基于469名女性的单中心经验对安全性和疗效的思考
Cureus. 2023 May 7;15(5):e38674. doi: 10.7759/cureus.38674. eCollection 2023 May.
5
Intraovarian Injection of Autologous Platelet-Rich Plasma Improves Therapeutic Approaches in The Patients with Poor Ovarian Response: A Before-After Study.卵巢内注射自体富血小板血浆改善卵巢反应不良患者的治疗方法:一项前后对照研究。
Int J Fertil Steril. 2022 Apr;16(2):90-94. doi: 10.22074/IJFS.2021.533576.1154. Epub 2022 May 8.
6
A narrative review of platelet-rich plasma (PRP) in reproductive medicine.富含血小板血浆(PRP)在生殖医学中的应用:综述
J Assist Reprod Genet. 2021 May;38(5):1003-1012. doi: 10.1007/s10815-021-02146-9. Epub 2021 Mar 15.
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PRP Injections for the Treatment of Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials.富血小板血浆注射治疗膝骨关节炎的疗效:一项随机对照试验的荟萃分析。
Cartilage. 2021 Dec;13(1_suppl):364S-375S. doi: 10.1177/1947603520931170. Epub 2020 Jun 19.
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Live Birth Rates in Poor Responders' Group after Previous Treatment with Autologous Platelet-Rich Plasma and Low Dose Ovarian Stimulation Compared with Poor Responders Used Only Low Dose Ovarian Stimulation Before in Vitro Fertilization.与仅在体外受精前使用低剂量卵巢刺激的低反应者相比,既往接受自体富血小板血浆和低剂量卵巢刺激治疗的低反应者组的活产率。
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