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评估富血小板血浆疗法对提高不孕症女性子宫内膜容受性的有效性:一项叙述性综述。

Evaluating the Effectiveness of Platelet Rich Plasma Therapy in Enhancing Endometrial Receptivity for Women with Infertility: A Narrative Review.

作者信息

Chatterjee Priya, Ghosh Shreya, Mahajan Sanket

机构信息

Department of Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India.

Clinical Embryology School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.

出版信息

J Pharm Bioallied Sci. 2025 May;17(Suppl 1):S137-S140. doi: 10.4103/jpbs.jpbs_1876_24. Epub 2025 Apr 21.

Abstract

Infertility is a condition that affects a significant percentage of couples globally, affecting their social and psychological well-being. It disrupts many aspects of life, influencing individuals' social and psychological experiences. The primary causes of infertility are diverse and include endogenous factors, various psychological variables, congenital or acquired disorders in females, and genetic and hormonal issues in males. In females, implantation failure is a key obstacle to successful embryo implantation, with poor endometrial receptivity being a major contributing factor. Several methods have been explored to enhance endometrial thickness and improve implantation success rates. These include treatments such as granulocyte-colony stimulating factor, low-dose acetylsalicylic acid, vaginal sildenafil, and estrogens. Among these, platelet-rich plasma (PRP) has emerged as a promising approach. PRP, derived from the patient's own blood, is rich in growth factors such as platelet-derived growth factor (PDGF), transforming growth factor (TGF), epidermal growth factor (EGF), and vascular endothelial growth factor (VEGF). These factors are crucial in promoting cell replication and tissue regeneration. PRP therapy has shown significant potential in enhancing endometrial proliferation and improving pregnancy rates, particularly in patients with thin endometrium and those with a history of recurrent implantation failure. Numerous studies have reported that intrauterine PRP treatment leads to increased endometrial thickness and better clinical pregnancy outcomes. The PRP is obtained through a centrifugation process that separates platelet-rich plasma from red blood cells. This PRP is then injected into the endometrial cavity, typically midcycle, to boost endometrial receptivity. Systematic reviews have consistently highlighted the positive effects of PRP treatment on pregnancy outcomes in women with thin endometrium, offering hope to those facing challenges with implantation and fertility. PRP therapy represents a promising advancement in reproductive medicine, providing an effective option for improving endometrial receptivity and achieving successful pregnancies.

摘要

不孕症是一种影响全球相当比例夫妇的疾病,会影响他们的社会和心理健康。它扰乱了生活的许多方面,影响着个人的社会和心理体验。不孕症的主要原因多种多样,包括内源性因素、各种心理变量、女性的先天性或后天性疾病以及男性的遗传和激素问题。在女性中,着床失败是胚胎成功着床的关键障碍,子宫内膜容受性差是一个主要促成因素。人们探索了几种方法来增加子宫内膜厚度并提高着床成功率。这些方法包括粒细胞集落刺激因子、低剂量乙酰水杨酸、阴道用西地那非和雌激素等治疗方法。其中,富血小板血浆(PRP)已成为一种有前景的方法。PRP来源于患者自身的血液,富含血小板衍生生长因子(PDGF)、转化生长因子(TGF)、表皮生长因子(EGF)和血管内皮生长因子(VEGF)等生长因子。这些因子在促进细胞复制和组织再生方面至关重要。PRP疗法在增强子宫内膜增殖和提高妊娠率方面显示出巨大潜力,特别是对于子宫内膜薄的患者和有反复着床失败病史的患者。许多研究报告称,宫腔内PRP治疗可增加子宫内膜厚度并改善临床妊娠结局。PRP是通过离心过程从红细胞中分离出富含血小板的血浆而获得的。然后将这种PRP注入子宫内膜腔,通常在月经周期中期,以提高子宫内膜容受性。系统评价一直强调PRP治疗对子宫内膜薄的女性妊娠结局的积极影响,为那些面临着床和生育挑战的人带来了希望。PRP疗法是生殖医学中一项有前景的进展,为改善子宫内膜容受性和实现成功妊娠提供了一种有效的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14d7/12156758/3c48f4b393f3/JPBS-17-137-g001.jpg

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