Experience with intrauterine platelet­rich plasma infusions for endometrial preparation in thawed embryo transfer programs in patients with an unfavorable prognosis of treatment outcomes

Savina V.A., Samoilovich Ya.A., Isakova E.V.

International Center of Reproductive Medicine, Saint Petersburg, Russia
Patients with chronic endometritis, thin endometrium, and repeated implantation failures are traditionally referred to the group with an unfavorable prognosis of treatment outcomes, by using assisted reproductive technologies (ART). There is no single tactics aimed at increasing the positive results of ART programs in this patient category.
Objective. To evaluate the experience in using intrauterine platelet-rich plasma (PRP) infusions in endometrial preparation in thawed embryo transfer programs in patients with an unfavorable prognosis of treatment outcomes.
Materials and methods. Twenty-eight case histories of patients were analyzed. The inclusion criteria were age < 42 years; a body mass index lower than 30 kg/m2; one or more histories of attempts at embryo transfer; and the quality of transferred embryos (AA, AB, and BB). The exclusion criteria were the use of donor oocytes and embryos; uterine pathology; genital anomalies; and Asherman’s syndrome. There were three patient groups: 1) repeated embryo implantation failures; 2) chronic endometritis; 3) thin endometrium. Preparation of the endometrium for thawed embryo transfer consisted in hormone replacement therapy. Seven days before embryo transfer, 1.0–1.5 ml of PRP was infused into the uterus. The endometrial thickness was measured over time and on the day of embryo transfer.
Results. In Group 1 (n=12), clinical pregnancy (CP) was recorded in 7 patients. Spontaneous abortion (SA) was observed in 1 patient. In Group 2, CP was confirmed in 6 patients, SA was noted in 2 women. Group 3 (n=15) showed a significant endometrial thickness increase (p=0.003). CP was seen in 9 patients; SA was recorded in 3 women.
Conclusion. It is advisable to use intrauterine PRP infusions in order to enhance the effectiveness of ART programs in patients with an unfavorable prognosis of treatment outcomes.

Keywords

platelet-rich plasma (PRP)
growth factors
endometrium
assisted reproductive technologies
repeated embryo implantation failures
chronic endometritis
thin endometrium

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Received 30.07.2020

Accepted 07.10.2020

About the Authors

Valentina A. Savina, Ph.D. in Medical sciences, obstetrician-gynecologist of Assisted Reproductive Technologies Department, International center for reproductive medicine. Tel.: +7(812)327-19-50. E-mail: savina@mcrm.ru. ORCID: 0000-0002-3252-0727; eLibrary SPIN: 8283-0209. 199034, Russia, Saint Petersburg, Кomendantskiy prospect, 53A.
Yanina A. Samoylovich, Ph.D., obstetrician-gynecologist of Assisted Reproductive Technologies Department, International center for reproductive medicine.
Tel.: +7(812)327-19-50. E-mail: yanasam@yandex.ru. ORCID: 0000-0003-2627-0028. 199034, Russia, Saint Petersburg, Кomendantskiy prospect, 53A.
Elvira V. Isakova, Ph.D. in Medical sciences, Head of Assisted Reproductive Technologies Department, International center for reproductive medicine.
Tel.: +7(812)327-19-50. E-mail: elvira@mcrm.ru. ORCID: 0000-0003-4462-6606. 199034, Russia, Saint Petersburg, Кomendantskiy prospect, 53A.

For citation: Savina V.A., Samoilovich Ya.A., Isakova E.V. Experience with intrauterine platelet-rich plasma infusions for endometrial preparation in thawed embryo transfer programs in patients with an unfavorable prognosis of treatment outcomes.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 11: 168-173 (in Russian).
https://dx.doi.org/10.18565/aig.2020.11.168-173

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