Autologous platelet rich plasma in complex therapy of women with refractory ‘‘thin’’ endometrium

Apolikhina, Apolikhina I.А.; Efendieva, Efendieva Z.N.; Fedorova, Fedorova T.A.; Belousov, Belousov D.M.; Vishnyakova, Polina; Artemova, Artemova D.A.; Fatkhudinov, Timur

doi:10.18565/aig.2021.4.112-119

Cited by 3 publications

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“…Frozen embryo transfer was done in 22 studies, fresh embryo transfer cycles were investigated in 2 studies [ 28 , 34 ], while in 3 studies the cycles included had both fresh and frozen embryo transfer [ 20 , 27 , 38 ]. All the studies evaluated intrauterine injection except Apolikhina [ 21 ], which evaluated subendometrial injection and Nourshin [ 32 ], which evaluated both intrauterine and subendometrial PRP injections. PRP was compared to no intervention or placebo in all 27 studies.…”

Section: Resultsmentioning

confidence: 99%

“…Endometrial thickness was compared in 4 RCTs with 307 participants and showed a mean difference of 0.93 with 0.59–1.27 95% CI between PRP and control cycles. Endometrial thickness was reported in 1 [23] and 3 studies [ 21 , 43 , 46 ] (96 and 211 women) with repeated implantation failure and thin endometrium and revealed an overall estimated mean difference of 1.00 and 0.89 with 95% CI of 0.85–1.15 and 0.28–1.49, respectively. It was also reported in 3 and 1 studies (211 and 96 women) with frozen and both frozen and fresh embryo transfer and revealed an overall estimated mean difference of 0.89 and 1.00 with 95% CI of 0.28–1.49 and 0.85–1.15, respectively.…”

Section: Resultsmentioning

confidence: 99%

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The value of platelet-rich plasma in women with previous implantation failure: a systematic review and meta-analysis

Maged

El-Mazny

Kamal

et al. 2023

J Assist Reprod Genet

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Objective To assess the value of intrauterine PRP to improve IVF outcome in women with previous implantation failure. Methods Screening of Pubmed, Web of Science, and other databases from inception to August 2022 using the keywords related to “platelet-rich plasma” OR “PRP” AND “IVF” “implantation failure.” Twenty-nine studies (3308 participants) were included in our analysis, 13 were RCTs, 6 were prospective cohorts, 4 were prospective single arm, and 6 were retrospective analyses. Extracted data included settings of the study, study type, sample size, participants’ characteristics, route, volume, timing of PRP administration, and outcome parameters. Results Implantation rate was reported in 6 RCTs (886 participants) and 4 non-RCTs (732 participants). The odds ratio (OR) effect estimate was 2.62 and 2.06, with 95% CI of 1.83, 3.76, and 1.03–4.11, respectively. Endometrial thickness was compared in 4 RCTs (307 participants) and 9 non-RCTs (675 participants), which showed a mean difference of 0.93 and 1.16, with 0.59–1.27 and 0.68–1.65 95% CI, respectively. Conclusion PRP administration improves implantation, clinical pregnancy, chemical pregnancy, ongoing pregnancy, live birth rates, and endometrial thickness in women with previous implantation failure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The value of platelet-rich plasma in women with previous implantation failure: a systematic review and meta-analysis

Maged

El-Mazny

Kamal

et al. 2023

J Assist Reprod Genet

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Evolution of biotechnological advances and regenerative therapies for endometrial disorders: a systematic review

Rodríguez-Eguren,

Bueno-Fernandez,

Gómez-Álvarez

et al. 2024

Human Reproduction Update

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BACKGROUND The establishment and maintenance of pregnancy depend on endometrial competence. Asherman syndrome (AS) and intrauterine adhesions (IUA), or endometrial atrophy (EA) and thin endometrium (TE), can either originate autonomously or arise as a result from conditions (i.e. endometritis or congenital hypoplasia), or medical interventions (e.g. surgeries, hormonal therapies, uterine curettage or radiotherapy). Affected patients may present an altered or inadequate endometrial lining that hinders embryo implantation and increases the risk of poor pregnancy outcomes and miscarriage. In humans, AS/IUA and EA/TE are mainly treated with surgeries or pharmacotherapy, however the reported efficacy of these therapeutic approaches remains unclear. Thus, novel regenerative techniques utilizing stem cells, growth factors, or tissue engineering have emerged to improve reproductive outcomes. OBJECTIVE AND RATIONALE This review comprehensively summarizes the methodologies and outcomes of emerging biotechnologies (cellular, acellular, and bioengineering approaches) to treat human endometrial pathologies. Regenerative therapies derived from human tissues or blood which were studied in preclinical models (in vitro and in vivo) and clinical trials are discussed. SEARCH METHODS A systematic search of full-text articles available in PubMed and Embase was conducted to identify original peer-reviewed studies published in English between January 2000 and September 2023. The search terms included: human, uterus, endometrium, Asherman syndrome, intrauterine adhesions, endometrial atrophy, thin endometrium, endometritis, congenital hypoplasia, curettage, radiotherapy, regenerative therapy, bioengineering, stem cells, vesicles, platelet-rich plasma, biomaterials, microfluidic, bioprinting, organoids, hydrogel, scaffold, sheet, miRNA, sildenafil, nitroglycerine, aspirin, growth hormone, progesterone, and estrogen. Preclinical and clinical studies on cellular, acellular, and bioengineering strategies to repair or regenerate the human endometrium were included. Additional studies were identified through manual searches. OUTCOMES From a total of 4366 records identified, 164 studies (3.8%) were included for systematic review. Due to heterogeneity in the study design and measured outcome parameters in both preclinical and clinical studies, the findings were evaluated qualitatively and quantitatively without meta-analysis. Groups using stem cell-based treatments for endometrial pathologies commonly employed mesenchymal stem cells (MSCs) derived from the human bone marrow or umbilical cord. Alternatively, acellular therapies based on platelet-rich plasma (PRP) or extracellular vesicles are gaining popularity. These are accompanied by the emergence of bioengineering strategies based on extracellular matrix (ECM)-derived hydrogels or synthetic biosimilars that sustain local delivery of cells and growth factors, reporting promising results. Combined therapies that target multiple aspects of tissue repair and regeneration remain in preclinical testing but have shown translational value. This review highlights the myriad of therapeutic material sources, administration methods, and carriers that have been tested. WIDER IMPLICATIONS Therapies that promote endometrial proliferation, vascular development, and tissue repair may help restore endometrial function and, ultimately, fertility. Based on the existing evidence, cost, accessibility, and availability of the therapies, we propose the development of triple-hit regenerative strategies, potentially combining high-yield MSCs (e.g. from bone marrow or umbilical cord) with acellular treatments (PRP), possibly integrated in ECM hydrogels. Advances in biotechnologies together with insights from preclinical models will pave the way for developing personalized treatment regimens for patients with infertility-causing endometrial disorders such as AS/IUA, EA/TE, and endometritis. REGISTRATION NUMBER https://osf.io/th8yf/

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A pilot study of the intrauterine non-ablative erbium laser effectiveness in the endometrium preparation for cryopreserved embryo transfer in women with a history of implantation failures

Пустотина

Gashenko

Ustinova³

et al. 2023

Gynecology

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Background. Embryo implantation failure remains an urgent issue of assisted reproductive technologies (ART). Aim. To determine the effect of intrauterine irradiation with a non-ablative erbium laser on the endometrium state using the histological and immunohistochemical examination and to evaluate its effectiveness in ART cryo-protocols. Materials and methods. The study enrolled 25 women aged 2645 with 1 to 5 failed implantations who were planning a pregnancy in a cryopreserved embryo transfer protocol. On days 610 of the menstrual cycle, all patients underwent a single procedure of intrauterine irradiation of the endometrium and cervical canal mucosa with an erbium laser in a non-ablative mode using Fotona SP Dynamis laser system (Slovenia). The histological and immunohistochemical data of the endometrium before and 12 months after the procedure and the pregnancy rate with subsequent transfer of the cryopreserved embryo were assessed. Results. Intrauterine irradiation with a non-ablative erbium laser increased the proliferative activity of the endometrium (p=0.029), the expression of vascular endothelial growth factor (p=0.029), reduced the sclerosis lesions in the spiral arteries and endometrial stroma, increased the expression of progesterone and estrogen receptors, thus significantly increasing the effectiveness of the ART cryo-protocols (p=0.013).

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Autologous platelet rich plasma in complex therapy of women with refractory ‘‘thin’’ endometrium

Cited by 3 publications

References 0 publications

The value of platelet-rich plasma in women with previous implantation failure: a systematic review and meta-analysis

The value of platelet-rich plasma in women with previous implantation failure: a systematic review and meta-analysis

Evolution of biotechnological advances and regenerative therapies for endometrial disorders: a systematic review

A pilot study of the intrauterine non-ablative erbium laser effectiveness in the endometrium preparation for cryopreserved embryo transfer in women with a history of implantation failures

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