Effects of autologous platelet-rich plasma in promoting endometrial thickness on patients with thin endometrium following IVF
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HIGHLIGHTS
- It was observed that autologous PRP substantially increased endometrial thickness in individuals experiencing infertility linked to a thin endometrium.
- The elevated clinical pregnancy rate emphasizes the favorable effectiveness of autologous PRP in addressing issues related to a thin endometrium in IVF programs.
ABSTRACT
Objective: The objective of this research was to investigate the impact of autologous platelet-rich plasma (PRP) in enhancing endometrial thickness among individuals experiencing infertility associated with a thin endometrium.
Materials and Methods: Nine individuals with a thin endometrium who participated in an in vitro fertilization (IVF) program were enrolled in the study. This study was carried out in Yasmin Clinic, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Patients underwent a hormone replacement protocol involving the preparation of the endometrium with estradiol valerate. Treatment with PRP was initiated when the endometrial thickness was less than 7 mm. Autologous PRP was infused into the uterine cavity between the 10th and 12th days after administering estradiol valerate, and the assessment of endometrial thickness was conducted using ultrasound 48 hours later. A second administration of PRP was provided in cases where the endometrial thickness was below 7 mm. Frozen-thawed embryo transfer (FET) was performed if the endometrium reached adequate thickness (minimum 7 mm).
Results: Seven of nine patients had adequate endometrial thickness followed by FET. Endometrial thickness was improved in 8 from 9 patients (88.8%). Five patients were improved at the first autologous PRP infusion (62.5%) and three patients (37.5%) at the second PRP infusion. The implantation rate was 33.3-100%, clinical pregnancy was 100%, and ongoing pregnancy rate was 83.3%.
Conclusion: The use of autologous platelet-rich plasma (PRP) successfully stimulates endometrial development in individuals with a thin endometrium during frozen-thawed embryo transfer.
Eftekhar M, Tabibnejad N, Tabatabaie AA. The correlation between endometrial thickness and pregnancy outcomes in fresh ART cycles with different age groups: a retrospective study. Middle East Fertility Society Journal. 2018; 23: 1-7. doi: 10.1186/s43043-019-0013-y.
Zadehmodarres S, Salehpour S, Saharkhiz N, et al. Treatment of thin endometrium with autologous platelet-rich plasma: a pilot study. JBRA Assist Reprod. 2017;21(1):54-6. doi: 10.5935/1518-0557. 20170013. PMID: 28333034; PMCID: PMC536 5202.
Rizov M, Andreeva P, Dimova I. Molecular regulation and role of angiogenesis in reproduction. Taiwan J Obstet Gynecol. 2017;56(2):127-32. doi: 10.1016/j.tjog.2016.06.019. PMID: 28420494.
Guo X, Yi H, Li TC, et al. Role of vascular endothelial growth factor (VEGF) in human embryo implantation: clinical implications. Biomolecules. 2021;11(2):253. doi: 10.3390/biom 11020253. PMID: 33578823; PMCID: PMC791 6576.
Trau HA, Davis JS, Duffy DM. Angiogenesis in the primate ovulatory follicle is stimulated by luteinizing hormone via prostaglandin E2. Biol Reprod. 2015;92(1):15. doi: 10.1095/biolreprod. 114.123711. Epub 2014 Nov 5. PMID: 25376231; PMCID: PMC4434930.
Gram A, Hoffmann B, Boos A, et al. Expression and localization of vascular endothelial growth factor A (VEGFA) and its two receptors (VEGFR1/FLT1 and VEGFR2/FLK1/KDR) in the canine corpus luteum and utero-placental compartments during pregnancy and at normal and induced parturition. Gen Comp Endocrinol. 2015;223:54-65. doi: 10.1016/j.ygcen.2015.09.020. Epub 2015 Sep 26. PMID: 26414127.
Sahoo G, Agrawal V. How to improve thin endometrium in cases of female infertility. Journal of South Asian Federation of Obstetrics and Gynaecology. 2018;10(2):81–3. doi: 10.5005/jp-journals-10006-1565.
Zhang X, Guo F, Wang Q, et al. Low-dose aspirin improves blood perfusion of endometrium of unexplained recurrent biochemical pregnancy loss. Int J Gynaecol Obstet. 2022;157(2):418-23. doi: 10.1002/ijgo.13838. Epub 2021 Aug 6. PMID: 34314517.
Kalem Z, Namli Kalem M, Bakirarar B, et al. Intrauterine G-CSF administration in recurrent implantation failure (RIF): An Rct. Sci Rep. 2020;10(1):5139. doi: 10.1038/s41598-020-61955-7. PMID: 32198409; PMCID: PMC7083859.
Moini A, Zafarani F, Jahangiri N, et al. The effect of vaginal sildenafil on the outcome of assisted reproductive technology cycles in patients with repeated implantation failures: A randomized placebo-controlled trial. Int J Fertil Steril. 2020; 13(4):289-95. doi: 10.22074/ijfs.2020.5681. Epub 2019 Nov 11. PMID: 31710189; PMCID: PMC687 5854.
Chang Y, Li J, Chen Y, et al. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization. Int J Clin Exp Med. 2015;8(1):1286-90. PMID: 25785127; PMCID: PMC4358582.
Dawood AS, Salem HA. Current clinical applications of platelet-rich plasma in various gynecological disorders: An appraisal of theory and practice. Clin Exp Reprod Med. 2018;45(2):67-74. doi: 10.5653/cerm.2018.45.2.67. Epub 2018 Jun 29. PMID: 29984206; PMCID: PMC6030616.
Maleki-Hajiagha A, Razavi M, Rouholamin S, et al. Intrauterine infusion of autologous platelet-rich plasma in women undergoing assisted reproduction: A systematic review and meta-analysis. J Reprod Immunol. 2020;137:103078. doi: 10.1016/j.jri. 2019.103078. Epub 2019 Dec 31. PMID: 32006776.
Wang X, Liu L, Mou S, et al. Investigation of platelet-rich plasma in increasing proliferation and migration of endometrial mesenchymal stem cells and improving pregnancy outcome of patients with thin endometrium. J Cell Biochem. 2019;120(5): 7403-11. doi: 10.1002/jcb.28014. Epub 2018 Dec 3. PMID: 30506864.
Kim H, Shin JE, Koo HS, et al. Effect of autologous platelet-rich plasma treatment on refractory thin endometrium during the frozen embryo transfer cycle: A pilot study. Front Endocrinol (Lausanne). 2019;10:61. doi: 10.3389/ fendo.2019.00061. PMID: 30837945; PMCID: PMC6382681.
Molina A, Sánchez J, Sánchez W, et al. Platelet-rich plasma as an adjuvant in the endometrial preparation of patients with refractory endo-metrium. JBRA Assist Reprod. 2018;22(1):42-8. doi: 10.5935/1518-0557.20180009. PMID: 29303 234; PMCID: PMC5844658.
Tandulwadkar SR, Naralkar MV, Surana AD, et al. Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: A pilot study. J Hum Reprod Sci. 2017;10(3):208-12. doi: 10.4103/jhrs. JHRS_28_17. PMID: 29142450; PMCID: PMC567 2727.
Kim H, Shin JE, Koo HS, et al. Effect of autologous platelet-rich plasma treatment on refractory thin endometrium during the frozen embryo transfer cycle: A pilot study. Front Endocrinol (Lausanne). 2019;10:61. doi: 10.3389/ fendo.2019.00061. PMID: 30837945; PMCID: PMC6382681.
Eftekhar M, Neghab N, Naghshineh E, et al. Can autologous platelet rich plasma expand endometrial thickness and improve pregnancy rate during frozen-thawed embryo transfer cycle? A randomized clinical trial. Taiwan J Obstet Gynecol. 2018;57(6):810-3. doi: 10.1016/j.tjog.2018.10.007. Erratum in: Taiwan J Obstet Gynecol. 2021 Sep;60(5):973. doi: 10.1016/j.tjog.2021.08.003. PMID: 30545532.
Nazari L, Salehpour S, Hoseini S, et al. Effects of autologous platelet-rich plasma on endometrial expansion in patients undergoing frozen-thawed embryo transfer: A double-blind RCT. Int J Reprod Biomed. 2019;17(6):443-8. doi: 10.18502/ijrm. v17i6.4816. PMID: 31508569; PMCID: PMC671 9514.
Liao Z, Liu C, Cai L, et al. The effect of endometrial thickness on pregnancy, maternal, and perinatal outcomes of women in fresh cycles after IVF/ICSI: A systematic review and meta-analysis. Front Endocrinol (Lausanne). 2022;12: 814648. doi: 10.3389/fendo.2021.814648. PMID: 35222 264; PMCID: PMC8874279.
Lin PY, Lee CI, Chen YC, et al. Factors affecting the potential efficacy of intrauterine platelet-rich plasma infusion on thin endometrium in women with recurrent implantation failure. J Pers Med. 2023;13(9):1419. doi: 10.3390/jpm13091419. PMID: 37763186; PMCID: PMC10532920.
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