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

Abstract

Objectives: Implantation failure is a major problem in reproductive medicine, and despite the various methods described for treatment, there is little consensus on the most effective method. This study was conducted to investigate the effect of intrauterine injection of platelet-rich plasma (PRP) on the pregnancy rate of patients with a history of implantation failure in the in vitro fertilization (IVF) cycle. Study Design: In this study, women attending the infertility clinic of Ali ibn Abi Taleb Hospital, who had a history of implantation failure and were candidates for frozen embryo transfer (FET), were examined in Zahedan (Iran) in 2019. The patients were divided into two groups of PRP recipients and the control group. IVF was performed routinely, and in the PRP-receiving group, an intrauterine injection was given 48 h before embryo transfer (ET). The number of gestational sacs, the rate of implantation, the frequency of chemical and clinical pregnancies as well as the frequency of abortion were compared in the two groups. The collected data were analyzed by the SPSS software version 21 Results: Ninety patients with a history of implantation failure participated in the study, and finally, the information of 85 patients was studied. The frequency of chemical pregnancy was 40% in the experimental group, 27% in the control group, and regarding clinical pregnancy, 33% in the experimental group and 24% in the control group, but there was no significant difference between the two groups. The rate of implantation, the mean thickness of the endometrium, and the frequency of abortion did not differ significantly between the two groups Conclusion: In patients with endometrial thickness greater than 8 mm with a history of recurrent implantation failure, intrauterine injection of PRP had no effect on the fertility outcome.

Efficacy of Platelet-Rich Plasma in Women with a History of Embryo Transfer Failure: A Systematic Review and Meta-Analysis with Trial Sequential Analysis

“…Qualitative synthesis was performed with the remaining 12 studies. Two studies did not provide enough data and were excluded from the quantitative me-ta-analysis [ 42 , 43 ].…”

“…In this systematic review, only RCTs that compared intrauterine PRP infusion before embryo transfer to no intervention or placebo group were included. Participants were women with a history of RIF [ 31 , 32 , 37 , 42 , 43 , 44 , 45 , 46 , 47 ] or TE [ 11 , 12 ]. Table 1 describes the principal characteristics of the selected studies.…”

“…Hormone replacement therapy (HRT) was applied to all participants, regardless the experimental group. Nine studies infused ≤1 mL PRP [ 11 , 12 , 31 , 32 , 37 , 42 , 44 , 45 , 46 ], and two studies administered >1 mL [ 38 , 47 ], whereas one trial did not provide this information [ 43 ]. None of the studies reported on the activation of the PRP before application.…”

“…Ten studies evaluated clinical pregnancy in 933 women with RIF [ 31 , 32 , 37 , 38 , 44 , 45 , 46 , 47 ] and 143 women with TE [ 11 , 12 ]. Clinical pregnancy was interpreted as the presence of fetal heartbeat in transvaginal ultrasound 5–6 weeks after embryo transfer in six studies [ 11 , 12 , 31 , 32 , 45 , 46 ].…”

“…Ten studies evaluated clinical pregnancy in 933 women with RIF [ 31 , 32 , 37 , 38 , 44 , 45 , 46 , 47 ] and 143 women with TE [ 11 , 12 ]. Clinical pregnancy was interpreted as the presence of fetal heartbeat in transvaginal ultrasound 5–6 weeks after embryo transfer in six studies [ 11 , 12 , 31 , 32 , 45 , 46 ]. Other study measured clinical pregnancy rate by dividing the number of fetal poles with an observed heartbeat in the 6-week-old sonogram by the number of the transferred embryos [ 37 ].…”