Use of platelet-rich autoplasma in the assisted reproductive technology programs
To date, the use of platelet-rich autoplasma (PRA) has become one of the new areas used in the assisted reproductive technology programs. Platelets contain a large number of growth factors and different types of proteins that are released after their activation. These factors accelerate cell mitosis, promote angiogenesis of endothelial cells, induce anti-inflammatory modulators, and support the production of fibrinogen that is essentially a framework for tissue regeneration. The intraovarial and intrauterine PRA administration has been used in reproductive medicine for the thin endometrium, premature ovarian insufficiency, and a low ovarian reserve.Zabrodina Yu.V., Akhmediyanova G.U., Khamidullina Z.G.
In preparing this review, we sought literature over the past 10 years to identify studies on the use of PRA therapy in the assisted reproductive technology programs.
Conclusion: The use of PRA is a new and rather promising method for infertility treatment in some women who are resistant to standard therapy. However, there is a need for additional prospective randomized controlled trials involving more participants to more significantly demonstrate the benefits of PRA therapy in clinical practice.
Authors' contributions: All authors have equally participated in the writing this article. Zabrodina Yu.V., Akhmediyanova G.U., Khamidullina Z.G. – material collection and processing, writing the text, editing.
Conflicts of interest: The authors of the article declare that there are no conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Zabrodina Yu.V., Akhmediyanova G.U., Khamidullina Z.G. Use of platelet-rich autoplasma in the assisted reproductive technology programs.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (7): 5-11 (in Russian)
https://dx.doi.org/10.18565/aig.2023.63
Keywords
PRA therapy
platelet-rich plasma
assisted reproductive technologies
in vitro fertilization
PRA and thin endometrium
PRA and low ovarian reserve
References
- Vander Borght M., Wyns C. Fertility and infertility: definition and epidemiology. Clin. Biochem. 2018, 62: 2-10. https://dx.doi.org/10.1016/j.clinbiochem.2018.03.012.
- Zegers-Hochschild F., Dyer S., Chambers G.M., Adamson G.D., Banker M., De Mouzon J. et al. ART utilization: an indicator of access to infertility care. Reprod. BioMed. Online. 2020; 41(1): 6-9. https://dx.doi.org/10.1016/j.rbmo.2020.03.007.
- Li F., Lu R., Zeng C., Li X., Xue Q. Development and validation of a clinical pregnancy failure prediction model for poor ovarian responders during IVF/ICSI. Front. Endocrinol. (Lausanne). 2021. 12: 717288.https://dx.doi.org/10.3389/fendo.2021.717288.
- Mahajan N., Sharma S. The endometrium in assisted reproductive technology: how thin is thin? J. Hum. Reprod. Sci. 2016; 9(1): 3-8.https://dx.doi.org/10.4103/0974-1208.178632.
- Zohni K.M., Gat I., Librach C. Recurrent implantation failure: a comprehensive review. Minerva Ginecol. 2016; 68(6): 653-67.
- Leijdekkers J.A., Eijkemans M.J.C., van Tilborg T.C., Oudshoorn S.C., McLernon D.J., Bhattacharya S. et al. Predicting the cumulative chance of live birth over multiple complete cycles of in vitro fertilization: an external validation study. Hum. Reprod. 2018; 33(9): 1684-95. https://dx.doi.org/10.1093/humrep/dey263.
- Zhang M., Tian H.-Q., Bu T., Li X., Wan X.-H., Wang D.-L. et al. Development and validation of a nomogram for predicting the probability of live birth in infertile women. Reprod. Dev. Med. 2019 3(2): 77-83. https://dx.doi.org/10.4103/2096-2924.262388.
- El-Danasouri I., Sterzik K., Rinaldi L., Pacchiarotti A., DeSanto M., Selman H. Effect of transferring a morphologically impaired embryo with a good quality embryo on the pregnancy and implantation rates. Eur. Rev. Med. Pharmacol. Sci. 2016; 20(3): 394-8.
- Gupta A.K., Renaud H.J., Rapaport J.A. Platelet-rich plasma and cell therapy the new horizon in hair loss treatment. Dermatol. Clin. 2021; 39(3): 429-45.https://dx.doi.org/10.1016/j.det.2021.04.001.
- Xu P., Wu Y., Zhou L., Yang Z., Zhang X., Hu X. et al. Platelet-rich plasma accelerates skin wound healing by promoting re-epithelialization. Burns Trauma. 2020; 8: tkaa028. https://dx.doi.org/10.1093/burnst/tkaa028.
- 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.
- Wu P.I., Diaz R., Borg-Stein J. Platelet-rich plasma. Phys. Med. Rehabil. Clin. N. Am. 2016; 27(4): 825-53. https://dx.doi.org/10.1016/ j.pmr.2016.06.002.
- Sharara F.I., Lelea L.L., Rahman S., Klebanoff J.S., Moawad G.N. A narrative review of platelet-rich plasma (PRP) in reproductive medicine. J. Assist. Reprod. Genet. 2021; 38(5): 1003-12. https://dx.doi.org/10.1007 / s10815-021-02146-9.
- Chang Y., Li J., Wei L.-N., Pang J., Chen J., Liang X. Autologous platelet-rich plasma infusion improves clinical pregnancy rate in frozen embryo transfer cycles for women with thin endometrium. Medicine (Baltimore). 2019; 98(3): e14062. https://dx.doi.org/10.1097/MD.0000000000014062.
- Tremellen K., Pacella-Ince L. An audit of clinical outcomes following ovarian administration of platelet-rich plasma (PRP) in women with severe diminished ovarian reserve. Aust. N. Z. J. Obstet. Gynaecol. 2022; 62(5): 767-72.https://dx.doi.org/10.1111/ajo.13578.
- Hsu C.-C., Hsu L., Hsu I., Chiu Y.-J., Dorjee S. Live birth in woman with premature ovarian insufficiency receiving ovarian administration of platelet-rich plasma (Prp) in combination with gonadotropin: a case report. Front. Endocrinol. (Lausanne). 2020; 11: 50. https://dx.doi.org/10.3389/fendo.2020.00050.
- Chang Y., Li J., Chen Y., Wei L., Yang X., Shi 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.
- Zadehmodarres S., Salehpour S., Saharkhiz N., Nazari L. Treatment of thin endometrium with autologous platelet-rich plasma: a pilot study. JBRA Assit. Reprod. 2017; 21(1): 54-6. https://dx.doi.org/10.5935/1518-0557.20170013.
- Tandulwadkar S., Naralkar M., Surana D., Selvakarthick M., Kharat A. 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.
- Eftekhar M., Neghab N., Naghshineh E., Khani P. 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. https://dx.doi.org/10.1016/j.tjog.2018.10.007.
- Nazari L., Salehpour S., Hosseini M., Moghanjoughi M. The effects of autologous platelet-rich plasma in repeated implantation failure: a randomized controlled trial. Hum. Fertil. (Camb). 2020; 23(3): 209-13. https://dx.doi.org/10.1080/14647273.2019.1569268.
- Доронина О.К., Дейлидко Э.Н. Применение аутоплазмы, обогащенной растворимыми факторами тромбоцитов при проведении программ экстракорпорального оплодотворения у пациенток с бесплодием и хроническим эндометритом. Акушерство и гинекология. 2019; 7: 72-6. [Doronina O.K., Deilidko E.N. The use of autoplasma, enriched with platelet-derived soluble factors, when carrying out the programs of in vitro fertilization (IFV) in patients with infertility and chronic endometritis. Obstetrics and Gynecology. 2019; (7): 72-6. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.7.72-76.
- Frantz N., Ferreira M., Kulmann M., Frantz G., Bos-Mikich A., Oliveira R. Platelet-rich plasma as an effective alternative approach for improving endometrial receptivity-a clinical retrospective study. JBRA Assist. Reprod. 2020; 24(4): 442-6. https://dx.doi.org/10.5935/1518-0557.20200026.
- Эфендиева З.Н., Аполихина И.А., Калинина Е.А., Федорова Т.А., Бакуридзе Э.М., Белоусов Д.М., Фатхудинов Т.Х., Сухих Г.Т. Первый опыт инъекционного введения аутологичной плазмы, обогащенной тромбоцитами, в эндометрий пациенток с маточным фактором бесплодия. Акушерство и гинекология. 2020; 4: 82-9. [Efendieva Z.N.,Apolikhina I.А., Kalinina Е.А., Fedorova Т.А., Bakuridze E.М.,Belousov D.М., Fathudinov Т.Kh., Sukhikh G.Т. First experience of autologous platelet rich plasma injection into the endometrium in patients with uterine factor infertility. Obstetrics and Gynecology. 2020; (4): 82-9.(in Russian)]. https://dx.doi.org/10.18565/aig.2020.4.82-89.
- Аполихина И.А., Эфендиева З.Н., Федорова Т.А., Белоусов Д.М., Вишнякова П.А., Артемова Д.А., Фатхудинов Т.Х. Обогащенная тромбоцитами аутологичная плазма в комплексной терапии женщин с рефрактерным «тонким» эндометрием. Акушерство и гинекология. 2021; 4: 112-9. [Apolikhina I.A., Efendieva Z.N., Fedorova T.A., Belousov D.M.,Vishnyakova P.A., Artemova D.A., Fatkhudinov T.Kh. Autologous platelet rich plasma in complex therapy of women with refractory ‘‘thin’’ endometrium. Obstetrics and Gynecology. 2021; (4): 112-9. (in Russian)].https://dx.doi.org/10.18565/aig.2021.4.112-119.
- 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. [Obidniak D.M., Gzgzyan A.M., Niauri D.A., Chkhaidze I.Z. Prospects for the use of autologous platelet-rich plasma in patients with recurrent implantation failure. Russian Journal of Human Reproduction. 2017; 23(5): 84 8. (in Russian)]. https://dx.doi.org/10.17116/repro201723584-88.
- Coksuer H., Akdemir Y., Barut M. Improved in vitro fertilization success and pregnancy outcome with autologous platelet-rich plasma treatment in unexplained infertility patients that had repeated implantation failure history. Gynecol. Endocrinol. 2019; 35(9): 815-8. https://dx.doi.org/10.1080/09513590.2019.1597344.
- Zamaniyan M., Peyvandi S., Heidaryan H., Moradi S., Jamal J. et al. Effect of platelet-rich plasma on pregnancy outcomes in infertile women with recurrent implantation failure: a randomized controlled trial. Gynecol. Endocrinol. 2021; 37(2): 141-5. https://dx.doi.org/10.1080/09513590.2020.1756247.
- Abduljabbar H., Howida H., Hanin H., Amal A., Najwan H. The effect of autologous platelet-rich plasma treatment on In vitro fertilization/intracytoplasmic sperm injection and its impact on the endometrium and clinical pregnancy rate. Cureus. 2022; 14(8): e27913. https://dx.doi.org/10.7759/cureus.27913.
- Li M., Kang Y., Wang Q., Lei Y. Efficacy of autologous intrauterine infusion of platelet-rich plasma in patients with unexplained repeated implantation failures in embryo transfer: a systematic review and meta-analysis. J. Clin. Med. 2022; 11(22): 6753. https://dx.doi.org/10.3390/jcm11226753.
- Nazari L., Salehpour S., Hosseini S., Sheibani S., Hosseinirad H. The effects of autologous platelet-rich plasma on pregnancy outcomes in repeated implantation failure patients undergoing frozen embryo transfer: a randomized controlled trial. Reprod. Sci. 2022; 29(3): 993-1000. https://dx.doi.org/10.1007/s43032-021-00669-1.
- Nazari L., Salehpour S., Hosseini S., Hashemi T., Borumandnia N., Azizi E. Effect of autologous platelet-rich plasma for treatment of recurrent pregnancy loss: a randomized controlled trial. Obstet. Gynecol. Sci. 2022; 65(3): 266-72.https://dx.doi.org/10.5468/ogs.21261.
- Ershadi S., Noori N., Dashipoor A., Ghasemi M., Shamsa N. Evaluation of the effect of intrauterine injection of platelet-rich plasma on the pregnancy rate of patients with a history of implantation failure in the in vitro fertilization cycle. J. Family Med. Prim. Care. 2022; 11(5): 2162-6. https://dx.doi.org/10.4103/jfmpc.jfmpc_1817_21.
- Pantos K., Simopoulou M., Pantou A., Rapani A., Tsioulou P., Nitsos N. et al. A case series on natural conceptions resulting in ongoing pregnancies in menopausal and prematurely menopausal women following platelet-rich plasma treatment. Cell Transplant. 2019; 28(9-10): 1333-40.https://dx.doi.org/10.1177/0963689719859539.
- Sills E., Wood S. Autologous activated platelet-rich plasma injection into adult human ovary tissue: molecular mechanism, analysis, and discussion of reproductive response. Biosci. Rep. 2019; 39(6): BSR20190805. https://dx.doi.org/10.1042/BSR20190805.
- Sills E., Rickers N., Li X., Palermo G. First data on in vitro fertilization and blastocyst formation after intraovarian injection of calcium gluconate-activated autologous platelet rich plasma. Gynecol. Endocrinol. 2018; 34(9): 756-60. https://dx.doi.org/10.1080/09513590.2018.1445219.
- Sfakianoudis K., Simopoulou M., Nitsos N., Rapani A., Pantou A., Vaxevanoglou T. et al. A case series on platelet-rich plasma revolutionary management of poor responder patients. Gynecol. Obstet. Invest. 2018; 84(1): 99-106.https://dx.doi.org/10.1159/000491697.
- Stojkovska S., Dimitrov G., Stamenkovska N., Hadzi-Lega M., Petanovski Z. Live birth rates in poor responders’ group after previous treatment with autologous platelet-rich plasma and low dose ovarian stimulation compared with poor responders used only low dose ovarian stimulation before in vitro fertilization. Open Access Maced. J. Med. Sci. 2019; 7(19): 3184-8.https://dx.doi.org/10.3889 /oamjms.2019.825.
- Cakiroglu Y., Saltik A., Yuceturk A., Karaosmanoglu O., Kopuk S., Scott R. et al. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency. Aging (Albany NY). 2020; 12(11): 10211-22.https://dx.doi.org/10.18632/aging.103403.
- Дубинская Е.Д., Гаспаров А.С., Дмитриева Н.В., Крылова Н.М. Интраовариальная аутоплазмотерапия у пациенток с низким овариальным резервом. Вопросы гинекологии, акушерства и перинатологии. 2021; 20(6): 72-80. [Dubinskaya E.D., Gasparov A.S., Dmitrieva N.V., Krylova N.M. Intraovarian autoplasmotherapy in patients with diminished ovarian reserve. Problems of Gynecology, Obstetrics and Perinatology. 2021; 20(6): 72-80.(in Russian)]. https://dx.doi.org/10.20953/1726-1678-2021-6-72-80.
Received 09.03.2023
Accepted 19.06.2023
About the Authors
Yuliya V. Zabrodina, Doctoral Candidate, 2nd year, specialty "Medicine", Astana Medical University, Astana, Kazakhstan, +77051151200, +77751655716,zabrodinayuliya@mail.ru, https://orcid.org/0000-0001-8972-0300, Astana, Saryarka str., 11, 126, Republic of Kazakhstan, 010000
Gainyl U. Akhmediyanova, PhD, Professor, Obstetrics and Gynecology Department One, Astana Medical University, Astana, Kazakhstan,
https://orcid.org/0000-0002-5410-7781
Zaituna G. Khamidullina, PhD, Head of the Obstetrics and Gynecology Department One, Astana Medical University, Astana, Kazakhstan,
https://orcid.org/0000-0002-0902-5269
Corresponding author: Yuliya V. Zabrodina, zabrodinayuliya@mail.ru