Effectiveness of Autologous Platelet-Rich Plasma Therapy in Women with Repeated Implantation Failure: A Randomized Clinical Trial

Document Type : Original Article

Authors

1 Research and Clinical Center for Infertility, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

2 Abortion Research Center, Yazd Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

Abstract

Background: Platelet-rich plasma (PRP) therapy has been shown to enhance tissue regeneration by expressing several
cytokines and growth factors (GFs). This study investigated the effect of intrauterine infusion of PRP as a noninvasive
autologous GF on pregnancy outcomes in women with repeated implantation failure.
Materials and Methods: This randomized clinical trial was conducted to compare the pregnancy rates between two
groups of women who were candidates for the frozen-thawed embryo transfer with a history of two or more implantation
failures. The PRP group (n=33) was treated with hormone replacement therapy+0.5 cc to 1 cc PRP infused
into the uterine cavity two days before the embryo transfer. The control group (n=33) was only treated with hormone
replacement therapy. The endometrial preparation process was done similarly in both groups. The chemical, clinical,
and ongoing pregnancy, and implantation rates were compared between the two groups.
Results: Our results showed that the chemical pregnancy rate was not statistically higher in the PRP group in comparison
with the control group (36.4 vs. 24.2%). In addition, the clinical pregnancy, ongoing pregnancy, and implantation
rates were higher in the PRP group than the control group; however, the difference between the two groups was not
statistically significant.
Conclusion: Administration of intrauterine PRP before embryo transfer in women with repeated implantation failure
(RIF) does not affect assisted reproductive technology (ART) outcomes (registration number: IRCT2016090728950N3).

Keywords

References

  1.  

    1. Dawood AS, Salem HA. 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.
    2. Franasiak JM, Scott Jr RT. Recurrent implantation failure. In: Franasiak JM, Scott Jr RT, editors. Etiologies and clinical management. Springer Cham; 2018.
    3. Li S, Wang J, Cheng Y, Zhou D, Yin T, Xu W, et al. Intrauterine administration of hCG-activated autologous human peripheral blood mononuclear cells (PBMC) promotes live birth rates in frozen/thawed embryo transfer cycles of patients with repeated implantation failure. J Reprod Immunol. 2017; 119: 15-22.
    4. Eftekhar M, Miraj S, Farid Mojtahedi M, Neghab N. Efficacy of Intrauterine infusion of granulocyte colony stimulating factor on patients with history of implantation failure: a randomized control trial. Int J Reprod Biomed. 2016; 14(11): 687-690.
    5. Salmassi A, Schmutzler AG, Schaefer S, Koch K, Hedderich J, Jonat W, et al. Is granulocyte colony-stimulating factor level predictive for human IVF outcome? Hum Reprod. 2005; 20(9): 2434-2440.
    6. Allahbadia G. The unfinished story of granulocyte colony-stimulating factor in assisted reproductive technology. IVF Lite. 2014; 1(3): 139-145.
    7. 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): 810-813.
    8. Chang Y, Li J, Wei LN, 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.
    9. Kim H, Shin JE, Koo HS, Kwon H, Choi DH, Kim JH. Effect of autologous platelet-rich plasma treatment on refractory thin endometrium during the frozen embryo transfer cycle: a pilot study. Front Endocrinol (Lausanne). 2019; 10: 61.
    10. Mehrafza M, Kabodmehri R, Nikpouri Z, Pourseify G, Raoufi A, Eftekhari A, et al. Comparing the impact of autologous platelet-rich plasma and granulocyte colony stimulating factor on pregnancy outcome in patients with repeated implantation failure. J Reprod Infertil. 2019; 20(1): 35-41.
    11. Nazari L, Salehpour S, Hosseini MS, Hashemi Moghanjoughi P. The effects of autologous platelet-rich plasma in repeated implantation failure: a randomized controlled trial. Hum Fertil (Camb). 2020; 23(3): 209-213.
    12. Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med. 2009; 37(11): 2259-2272.
    13. Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Platelet-rich therapies in the treatment of orthopaedic sport injuries. Sports Med. 2009; 39(5): 345-354.
    14. Molina A, Sánchez J, Sánchez W, Vielma V. Platelet-rich plasma as an adjuvant in the endometrial preparation of patients with refractory endometrium. JBRA Assist Reprod. 2018; 22(1): 42-48.
    15. 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): 1286-1290.
    16. Tandulwadkar SR, Naralkar MV, Surana AD, Selvakarthick M, Kharat AH. Autologous intrauterine platelet-rich plasma instillation for suboptimal endometrium in frozen embryo transfer cycles: a pilot study. J Hum Reprod Sci. 2017; 10(3): 208-212.
    17. Tehraninejad ES, Kashani NG, Hosseini A, Tarafdari A. Autologous platelet-rich plasma infusion does not improve pregnancy outcomes in frozen embryo transfer cycles in women with history of repeated implantation failure without thin endometrium. J Obstet Gynaecol Res. 2021; 47(1): 147-151.
    18. Maleki-Hajiagha A, Razavi M, Rouholamin S, Rezaeinejad M, Maroufizadeh S, Sepidarkish M. Intrauterine infusion of autologous platelet-rich plasma in women undergoing assisted reproduction: A systematic review and meta-analysis. J Reprod Immunol. 2020; 137: 103078.
    19. 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): 54-56.
    20. Farimani M, Bahmanzadeh M, Poorolajal J. A new approach using autologous platelet-rich plasma (PRP) to treat infertility and to improve population replacement rate. J Res Health Sci. 2016; 16(3): 172-173.
    21. Garcia-Velasco JA, Acevedo B, Alvarez C, Alvarez M, Bellver J, Fontes J, et al. Strategies to manage refractory endometrium: state of the art in 2016. Reprod Biomed Online. 2016; 32(5): 474-489.
    22. Farimani M, Poorolajal J, Rabiee S, Bahmanzadeh M. Successful pregnancy and live birth after intrauterine administration of autologous platelet-rich plasma in a woman with recurrent implantation failure: a case report. Int J Reprod Biomed. 2017; 15(12): 803-806.
    23. 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): 625-628.
    24. Obidniak D, Gzgzyan A, Feoktistov A, Niauri D. Randomized controlled trial evaluating efficacy of autologous platelet-rich plasma therapy for patients with recurrent implantation failure. Fertil Steril. 2017; 108(3): e370.
    25.  

     

International Journal of Fertility and Sterility
Volume 18, Issue 2
April 2024
Pages 162-166

Files

Share

How to cite

Statistics