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

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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.

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Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis

Flavia T S Elias, Danielle Weber-Adrian, Jessica Pudwell … (2020)

Purpose The use of assisted reproductive technology (ART) has increased in the last 2 decades and continuous surveillance is needed. This systematic review aims to assess the risk of adverse neonatal outcomes (preterm birth [PTB], low birth weight [LBW], small-for-gestationalage [SGA] and large for gestational-age [LGA]), in singleton pregnancies conceived by fresh or frozen embryo transfer (FET) compared to spontaneous conceptions. Methods Cohort studies were identified from MEDLINE, Embase, Cochrane Library (January 2019), and manual search. Meta-analyses were performed to estimate odds ratios (OR) using random effects models in RevMan 5.3 and I-squared (I 2) test > 50% was considered as high heterogeneity. Results After 3142 titles and abstracts were screened, 1180 full-text articles were assessed, and 14 were eligible. For fresh embryo transfer, the pooled ORs were PTB 1.64 (95% CI 1.46, 1.84); I 2 = 97%; LBW 1.67 (95% CI 1.52, 1.85); I 2 = 94%; SGA 1.46 [95% CI 1.11, 1.92]; I 2 = 99%, LGA 0.88 (95% CI 0.80, 0.87); I 2 = 80%). For frozen, the pooled ORs were PTB 1.39 (95% CI 1.34, 1.44); I 2 = 0%; LBW 1.38 (95% CI 0.91, 2.09); I 2 = 98%; SGA 0.83 (95% CI 0.57, 1.19); I 2 = 0%, LGA 1.57 (95% CI 1.48, 1.68); I 2 = 22%). Conclusions When compared with spontaneous pregnancies, fresh, but not frozen was associated with LBW and SGA. Both fresh and frozen were associated with PTB. Frozen was uniquely associated with LGA. Despite improvements in ART protocols in relation to pregnancy rates, attention is needed towards monitoring adverse neonatal outcomes in these pregnancies. Electronic supplementary material The online version of this article (10.1007/s00404-020-05593-4) contains supplementary material, which is available to authorized users.

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Hypertensive complications of pregnancy: A clinical overview

V. Kotsis, C Antza, R Cífková (2017)

Hypertensive disorders in pregnancy are a worldwide health problem for women and their infants complicating up to 10% of pregnancies and associated with increased maternal and neonatal morbidity and mortality. In Europe, 2.3-3% of pregnancies are complicated by preeclampsia. Gestational diabetes, obesity, no previous or multiple births, maternal age less than 20 or greater than 35years old and thrombophilia can be some of the possible factors related to increased risk for hypertension in pregnancy. Complications of hypertension during pregnancy affect both mothers and their infants. Ambulatory blood pressure monitoring helps to distinguish true hypertension from the white coat as pregnant women with office abnormal values may have normal out of office blood pressure. Imbalance between proangiogenic and antiangiogenic factors in placenta may lead to endothelial dysfunction, vasoconstriction, activation of the coagulation system, and hemolysis. Carotid intima-media thickness, pulse wave velocity, augmentation index, and arterial wall tension were found to be significantly increased in women with preeclampsia compared to normotensive pregnant women. Uterine artery Doppler and serum biomarkers can be used to evaluate the probability of hypertension and complications during pregnancy, but further research in the field is needed. Lately, micro ribonucleic acids have also been the focus of research as potential biomarkers.

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The effects of autologous platelet-rich plasma in repeated implantation failure: a randomized controlled trial

Leila Nazari, Saghar Salehpour, Maryam Sadat Hosseini … (2020)

Repeated implantation failure is a major challenge in reproductive medicine and despite several methods that have been described for management, there is little consensus on which is the most effective. This study was conducted to evaluate the effectiveness of autologous platelet-rich plasma in improving the pregnancy rate in repeated implantation failure. Between 2016 and 2017, a total of 138 patients who failed to conceive after 3 or more embryo transfers with high quality embryos and candidate for frozen-thawed embryo transfer were assessed for eligibility to enter the study. Intrauterine infusion of 0.5 ml platelet-rich plasma (PRP) that contained platelets at 4-5 times higher concentration than peripheral blood was performed 48 h before blastocyst transfer. A control group received standard treatment. Ninety-seven patients completed the study procedure. There were no significant differences between the two groups in terms of age, body mass index and number of previous embryo transfers. The chemical pregnancy rate was higher in the PRP group than control group (53.06% versus 27.08%, respectively; p value: 0.009). Clinical pregnancy rate was higher in PRP group than control group (44.89% versus 16.66%, respectively; p value: 0.003). In conclusion, intrauterine platelet-rich plasma may be effective in the improvement of pregnancy outcome in repeated implantation failure.

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Author and article information

Contributors

Tahereh Madani:

ORCID: http://orcid.org/0000-0001-9670-3904

tahereh.madani@gmail.com

Mehri Mashayekhi:

ORCID: http://orcid.org/0000-0001-5907-7203

dr.mashayekhy@yahoo.com

Journal

Journal ID (nlm-ta): Sci Rep

Journal ID (iso-abbrev): Sci Rep

Title: Scientific Reports

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2045-2322

Publication date (Electronic): 29 October 2024

Publication date PMC-release: 29 October 2024

Publication date Collection: 2024

Volume: 14

Electronic Location Identifier: 26009

Affiliations

[1 ]Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, ( https://ror.org/02exhb815) Tehran, Iran

[2 ]Department of Basic and Population Based Studies in NCD, Reproductive Epidemiology Research Center, Royan Institute, ACECR, ( https://ror.org/02exhb815) Tehran, Iran

Author information

Azar Yahyaei http://orcid.org/0000-0002-3834-7646

Tahereh Madani http://orcid.org/0000-0001-9670-3904

Samira Vesali http://orcid.org/0000-0003-0005-8045

Mehri Mashayekhi http://orcid.org/0000-0001-5907-7203

Article

Publisher ID: 77578

DOI: 10.1038/s41598-024-77578-1

PMC ID: 11522411

PubMed ID: 39472511

SO-VID: b8aca124-5318-4706-b3ef-33417d385e3a

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Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

History

Date received : 30 July 2024

Date accepted : 23 October 2024

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ScienceOpen disciplines: Uncategorized

Keywords: platelet-rich plasma,recurrent implantation failure,unexplained infertility,fresh embryo transfer,frozen embryo transfer,pregnancy outcome,endocrinology,medical research

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ScienceOpen disciplines: Uncategorized

Keywords: platelet-rich plasma, recurrent implantation failure, unexplained infertility, fresh embryo transfer, frozen embryo transfer, pregnancy outcome, endocrinology, medical research

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

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International Journal of Medicine and Medical Research

Most cited references 26

Neonatal outcomes in singleton pregnancies conceived by fresh or frozen embryo transfer compared to spontaneous conceptions: a systematic review and meta-analysis

Hypertensive complications of pregnancy: A clinical overview

The effects of autologous platelet-rich plasma in repeated implantation failure: a randomized controlled trial

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