Use of autologous platelet­rich plasma in infertility and miscarriage

Kovalev M.V., Vartanyan E.V., Dobrokhotova Yu.E., Tsaturova K.A., Devyatova E.A.

1) Department of Obstetrics and Gynecology, N.I. Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, Moscow, Russia; 2) “Test-Tube Baby” Clinic of Assisted Reproductive Technologies, Moscow, Russia
The paper reviews the data available in modern foreign and Russian literature on the practical use of autologous platelet-rich plasma (PRP) in patients with infertility. It reflects the main directions, key aspects, duration and level of clinical trials studying PRP and considers a range of effects of the technology used in clinical practice. PRP is noted to be of value in correcting infertility-accompanying pathological conditions, including chronic endometritis, as well as in applying assisted reproductive technologies. The paper is aimed at finding solutions to the problem associated with fertility restoration in women with the functionally defective endometrium.
Conclusion. The results of scientific research obtained to date may suggest that the use of PRP may become a promising treatment after recurrent implantation failures in IVF programs, but also that of patients with miscarriage.

Keywords

autologous platelet-rich plasma
PRP
implantation
chronic endometritis
infertility
miscarriage

References

  1. Inhorn M.C., Patrizio P. Infertility around the globe: new thinking on gender, reproductive technologies and global movements in the 21st century. Hum. Reprod. Update. 2015; 21(4): 411-26. https://dx.doi.org/10.1093/humupd/dmv016.
  2. Datta J., Palmer M.J., Tanton C., Gibson L.J., Jones K.G., Macdowall W. et al. Prevalence of infertility and help seeking among 15 000 women and men. Hum. Reprod. 2016; 31(9): 2108-18. https://dx.doi.org/10.1093/humrep/dew123.
  3. Здравоохранение в России 2017. Статистический сборник. Росстат. М.; 2017. 170 с. [Healthcare in Russia 2017. Stat. proceedings of the Rosstat. M. 2017; 170 p. (in Russian)].
  4. ESHRE Early Pregnancy Guideline Development Group. Recurrent pregnancy loss. November 2017. 153 p. Available at: https://www.eshre.eu/Guidelines-and-Legal/Guidelines/Recurrent-pregnancy-loss Accessed 12.04.2020.
  5. Регистр ВРТ РАРЧ. Отчет за 2017 год. СПб.: Лакшери Принт; 2019. 39 с. [Register VRT Rahr. Report for 2017. SPB.: Luxury Print, 2019. 39 p. (in Russian)].
  6. Kasius A., Smit J.G., Torrance H.L., Eijkemans M.J., Mol B.W., Opmeer B.C., Broekmans F.J. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum. Reprod. Update. 2014; 20(4): 530-41. https://dx.doi.org/10.1093/humupd/dmu011.
  7. Файзулина Д.И., Фаткуллин И.Ф., Илизарова Н.А. Современные возможности таргетной профилактики имплантационной недостаточности эндометрия. Современные проблемы науки и образования. 2018; 6: 79. Available at: https://www.science-education.ru/ru/article/view?id=28309 Accessed 13.04.2020. [Fayzulina D.I., Fatkullin I.F., Ilizarova N.A. Modern possibilities of targeted prevention of endometrial implantation insufficiency. Modern problems of science and education. 2018; 6: 79. (in Russian)].
  8. Сулаева О.Н. Получение богатой тромбоцитами плазмы: мифы и реальность. Світ медицини та біології. 2017; 13(3): 150-3. [Sulaeva O.N. Obtaining platelet-rich plasma: myths and reality. The world of medicine and biology. 2017;3(61):150-3. (in Russian)].
  9. Cole B.J., Seroyer S.T., Filardo G., Bajaj S., Fortier L.A. Platelet-rich plasma: where are we now and where are we going? Sports Health. 2010; 2(3): 203-10. https://dx.doi.org/10.1177/1941738110366385.
  10. Ачкасов Е.Е., Ульянов А.А., Безуглов Э.Н. Использование аутоплазмы, обогащенной тромбоцитарными факторами роста, в лечении больных с абсцессом эпителиального копчикового хода. Хирургия. Журнал им. Н.И. Пирогова. 2013; 12: 43-7. [Achkasov E.E., Ulyanov A.A., Bezuglov E.N. Use of autoplasm enriched with platelet growth factors in the treatment of patients with epithelial coccygeal abscess. Surgery. 2013;12:43-7. (in Russian)].
  11. Hussai N., Johal H., Bhandari М. An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature. SICOT J. 2017; 3: 57. https://dx.doi.org/10.1051/sicotj/2017036.
  12. Dhillon R.S., Edward M., Schwarz E.M., Maloney M.D. Platelet-rich plasma therapy – future or trend? Arthritis Res. Ther. 2012; 14(4): 219. https://dx.doi.org/10.1186/ar3914. Available at: http://arthritis-research.com/content/14/4/219 Accessed 12.04.2020.
  13. Dawood A.S., Salem H.A. 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. https://dx.doi.org/10.5653/cerm.2018.45.2.67.
  14. Медведев В.Л., Опольский А.М., Коган М.И. Перспективы развития регенеративных технологий. Современные знания об аутоплазме, обогащенной тромбоцитами и возможности ее применения в лечении урологических заболевании. Кубанский научный медицинский вестник. 2018; 25(3): 155-61. https://dx.doi.org/10.25207/16086228-2018-25-3-155-161. [Medvedev V.L., Opolsky A.M., Kogan M.I. Prospects for the development of regenerative technologies. Modern knowledge of autoplasma, enriched with platelets and the possibility of its use in the treatment of urological disease. Kuban scientific medical Bulletin. 2018; 25(3): 155-61. (in Russian)]. https://dx.doi.org/10.25207/16086228-2018-25-3-155-161.
  15. Jain A., Bedi R.K. Mittal K. Platelet-rich plasma therapy: A novel application in regenerative medicine. Asian J. Transfus. Sci. 2015; 9(2): 113-4. https://dx.doi.org/10.4103/0973-6247.162679.
  16. Конторщикова К.Н., Шахова К.А., Янченко О.С., Тихомирова Ю.Р., Булат В.В., Булат А.В. Определение тромбоцитарных факторов роста в необогащенной тромбоцитами плазмe. Медицинский альманах. 2018; 2: 41-4. [Kontorshchikova K.N., Shakhova K.A., Yanchenko O.S. et al. Determination of platelet growth factors in non-platelet-rich plasma. Medical almanac. Laboratory diagnostics. 2018;2(53):41-4. (in Russian)].
  17. Железная А.А., Цвяшко Т.И., Кнуров И.Ю., Шаповалов А.Г., Петров А.Г., Лунева Н.Н. Применение обогащенной тромбоцитами аутоплазмы в акушерско-гинекологической практике. Медико-социальные проблемы семьи. 2016; 21(1): 72-8. [Zheleznaya A.A., Cvyashko T.I., Knurov I.Yu. et al. The use of platelet-rich autoplasma in obstetric practice. Medical and social problems of the family. 2016;21(1):72-8. (in Russian)].
  18. Гаин Ю.М., Герасименко М.А., Шахрай С.В., Хрыщанович В.Я., Богдан В.Г., Бордаков П.В., Гаин М.Ю. Возможности и перспективы использования обогащенной тромбоцитами плазмы в хирургии и медицине. Инновационные технологии в медицине. 2017; 3: 104-24. [Gain Yu.M., Gerasimenko M.A., Shakhray S.V. et al. Possibilities and prospects of using platelet-rich plasma in surgery and medicine. Innovative technologies in medicine: lectures and reviews. 2017;5(3):104-24. (in Russian)].
  19. O’Connell B., Wragg N.M., Wilson S.L. The use of PRP injections in the management of knee osteoarthritis. Cell Tissue Res. 2019; 376(2): 143-52. https://dx.doi.org/10.1007/s00441-019-02996-x.
  20. Хитрик А.Й., Макеева Л.В., Завгородняя М.И., Сулаева О.Н. Морфогенетические эффекты тромбоцитов на течение раневого процесса. Вісник проблем біології і медицини. 2015; 4-2: 54-8. [Khitrik A.I., Makeeva L.V., Zavgorodnyaya M.I., Sulaeva O.N. Morphogenetic effects of platelets on the course of the wound process. Bulletin of problems of biology and medicine. 2015;4-2(125):54-8. (in Russian)].
  21. Ehrenfest D.M., Rasmusson L., Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotech. 2009; 27(3): 158-67. https://dx.doi.org/10.1016/j.tibtech.2008.11.009.
  22. Simon A., Laufer N. Assessment and treatment of repeated implantation failure (RIF). J. Assist. Reprod. Genet. 2012; 29(11): 1227-39. https://dx.doi.org/10.1007/s10815-012-9861-4.
  23. Доронина О.К., Дейлидко Э.Н. Новый метод лечения бесплодия при экстракорпоральном оплодотворении. Охрана материнства и детства. 2018; 2: 15-8. [Doronina O.K., Dalidko E.N. A new method of treating infertility in extracorporeal fertilization. Protection of motherhood and childhood. 2018; 2(32): 15-8. (in Russian)].
  24. Wiesenfeld H.C., Hillier S.L., Meyn L.A., Amortegui A.J., Sweet R.L. Subclinical pelvic inflammatory disease and infertility. Obstet. Gynecol. 2012; 120(1): 37-43. https://dx.doi.org/10.1097/AOG.0b013e31825a6bc9.
  25. Krivonos M.I., Kh Khizroeva J., Zainulina M.S., Eremeeva D.R., Selkov S.A., Chugunova A. et al. The role of lymphocytic cells in infertility and reproductive failures in women with antiphospholipid antibodies. J. Matern. Fetal Neonatal Med. 2020; Feb. 25: 1-7. https://dx.doi.org/10.1080/14767058.2020.1732343.
  26. Zheng X., O'Connell C.M., Zhong W., Poston T.B., Wiesenfeld H.C., Hillier S.L. et al. Gene expression signatures can aid diagnosis of sexually transmitted infection-induced endometritis in women. Front. Cell. Infect. Microbiol. 2018; 8: 307. https://dx.doi.org/10.3389/fcimb.2018.00307.
  27. Пестрикова Т.Ю., Юрасов И.В., Юрасова Е.А., Ковалева Т.Д., Лосева Е.В., Замотаева Е.Б. Коррекция гемостаза и гемодинамических нарушений в сосудах матки у пациенток с хроническими формами воспалительных заболеваний органов малого таза. Consilium Medicum. 2014; 16(6): 94-6. [Pestrikova T.Yu., Yurasov I.V., Yurasova E.A. et al. Correction of hemostasis and hemodynamic disorders in the uterine vessels in patients with chronic forms of pelvic inflammatory diseases. Rational pharmacotherapy. 2014; 16(6): 94-6. (in Russian)].
  28. Cicinelli E., Matteo M., Tinelli R., Lepera A., Alfonso R., Indraccolo U. et al. Prevalence of chronic endometritis in repeated unexplained implantation failure and the IVF success rate after antibiotic therapy. Hum. Reprod. 2015; 30(2): 323-30. https://dx.doi.org/10.1093/humrep/deu292.
  29. Кузнецова И.В., Землина Н.С., Рашидов Т.Н., Коваленко М.А. Проблема тонкого эндометрия и возможные пути ее решения. Эффективная фармакотерапия. Акушерство и гинекология. 2015; 5: 42-9. [Kuznetsova I.V.,Zemlina N.S., Rashidov T.N., Kovalenko M.A. The problem of thin endometrium and possible ways to solve it. Effective pharmacotherapy. Obstetrics and gynecology. 2015;1(5):42-9. (in Russian)].
  30. Обидняк Д.М., Гзгзян А.М., Ниаури Д.А., Чхаидзе И.З. Перспективы применения аутологичной обогащенной тромбоцитами плазмы крови у пациенток с повторными неэффективными попытками имплантации. Проблемы репродукции. 2017; 23(5): 84-8. https://dx.doi.org/10.17116/repro201723584-88. [Obidnyak D.M., Gzgzyan A.M., Niauri D.A. et al. Prospects for using autologous platelet-rich blood plasma in patients with repeated ineffective implantation attempts. Reproduction problems. 2017;5:84-8. (in Russian)].
  31. Chang Y., Li J., Chen Y., Wei L., Yang X., Shi Y., Liang X. 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.
  32. Nazari L., Salehpour S., Hoseini S., Zadehmodarres S., Ajori L. Effects of autologous platelet-rich plasma on implantation and pregnancy in repeated implantation failure: A pilot study. Int. J. Reprod. Biomed. 2016;14(10): 625-8.
  33. Tandulwadkar S.R., Naralkar M.V., Surana A.D., Selvakarthick M., Kharat A.H. 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. https://dx.doi.org/10.4103/jhrs.JHRS_28_17.
  34. Половнева М.И., Корнеева И.Е., Бурменская О.В. Современные методы воздействия, направленные на повышение рецептивности эндометрия у пациенток с безуспешными попытками экстракорпорального оплодотворения (обзор литературы). Гинекология. 2018; 20(3): 66-70. [Polovneva M.I., Korneeva I.E., Burmenskaya O.V. Modern methods of influence aimed at increasing endometrial receptivity in patients with unsuccessful attempts of in vitro fertilization (literature review). Gynecology. 2018;20(3):66-70. (in Russian)]. https://dx.doi.org/10.26442/2079-5696_2018.3.66-70.
  35. Zadehmodarres S., Salehpour S., Saharkhiz N., Nazari L. Treatment of thin endometrium with autologous platelet-rich plasma: a pilot study. JBRA Assist. Reprod. 2017; 21(1): 54-6. https://dx.doi.org/10.5935/1518-0557.20170013.

Received 07.05.2020

Accepted 05.06.2020

About the Authors

Maxim V. Kovalev, hematologist, obstetrician-gynecologist, LLC “Test-Tube Babies” Clinic for Assisted Reproductive Technologies.
Tel.: +7(495)981-85-80. E-mail: kovaleff@yandex.ru. ORCID: 0000-0002-1095-4700. eLibrary SPIN-code: 6645-5193. 123182, Russia, Moscow, Shchukinskaya str., 2.
Emma V. Vartanyan, MD, Assistant Professor, Professor of the Department of Obstetrics and Gynecology, N.I. Pirogov Russian National Research Medical University; President of the self-regulating society Association of ART Clinics, Director of LLC “Test-Tube Babies” Clinic for Assisted Reproductive Technologies, obstetrician-gynecologist, reproductive specialist. Tel.: +7(495)981-85-80. E-mail: info@baby-ivf.ru. ORCID: 0000-0003-0337-086X. eLibrary SPIN- code: 7922-7936.
123182, Russia, Moscow, Shchukinskaya str., 2.
Yulia E. Dobrohotova, MD, Professor, Chief of the Department of Obstetrics and Gynecology, N.I. Pirogov Russian National Research Medical University.
Tel.: +7(495)434-36-90. E-mail: rsmu@rsmu.ru. ORCID: 0000-0002-7830-2290, eLibrary SPIN- code: 2925-9948, Scopus Author ID: 57188592250.
117997, Russia, Moscow, Ostrovityanova str., 1.
Kristina A. Tsaturova, PhD, Chief of LLC “Test-Tube Babies” Clinic for Assisted Reproductive Technologies, obstetrician-gynecologist, reproductive specialist.
Tel.: +7(495)981-85-80. E-mail: info@baby-ivf.ru. ORCID: 0000-0002-1095-4700. eLibrary SPIN- code: 6645-5193. 123182, Russia, Moscow, Shchukinskaya str., 2.
Ekaterina A. Devyatova, MD, doctor of ultrasound diagnostics, obstetrician-gynecologist, LLC “Test-Tube Babies” Clinic for Assisted Reproductive Technologies.
Tel.: +7(495)981-85-80. E-mail: devyatova@baby-ivf.ru. ORCID: 0000-0003-1533-1593. eLibrary SPIN- code: 1298-3699. 123182, Russia, Moscow, Shchukinskaya str., 2.1

For citation: Kovalev M.V., Vartanyan E.V., Dobrokhotova Yu.E., Tsaturova K.A., Devyatova E.A. Use of autologous platelet-rich plasma in infertility and miscarriage.
Akusherstvo i Ginekologiya/ Obstetrics and Gynecology. 2020; 11: 33-38 (in Russian).
https://dx.doi.org/10.18565/aig.2020.11.33-38

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