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Nagy B, Kovács K, Sulyok E, Várnagy Á, Bódis J. Thrombocytes and Platelet-Rich Plasma as Modulators of Reproduction and Fertility. Int J Mol Sci 2023; 24:17336. [PMID: 38139165 PMCID: PMC10744025 DOI: 10.3390/ijms242417336] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Thrombocytes play an essential role in hemostasis and thrombosis. Moreover, the controlled activation of thrombocytes is required in reproduction and fertility. The platelet-activating factor and the controlled activation of platelets have important roles in folliculogenesis, ovulation, placental development, implantation and embryo development. Activated platelets accumulate in the follicular vessels surrounding the follicle and, due to its released soluble molecules (factors, mediators, chemokines, cytokines, neurotransmitters), locally increase oocyte maturation and hormone secretion. Furthermore, activated platelets are involved in the pathogenesis of ovarian hyperstimulation syndrome (OHSS) and preeclampsia. Low-dose aspirin can prevent OHSS during ovulation induction, while intrauterine or intraovarian administration of platelet-rich plasma (PRP) increases the endometrium thickness and receptivity as well as oocyte maturation. Activated thrombocytes rapidly release the contents of intracellular granules and have multiple adhesion molecules and receptors on their surface. Considering the numerous homeostatic endocrine functions of thrombocytes, it is reasonable to suppose a platelet-associated regulatory system (PARS) in reproduction. Although we are far from a complete understanding of the regulatory processes, the results of PARS research and the therapeutic application of aspirin and PRP during in vitro fertilization are promising.
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Affiliation(s)
- Bernadett Nagy
- National Laboratory on Human Reproduction, 7624 Pécs, Hungary; (K.K.); (E.S.); (Á.V.); (J.B.)
- Department of Obstetrics and Gynecology, University of Pécs, 7624 Pécs, Hungary
- HUN-REN–PTE Human Reproduction Research Group, 7624 Pécs, Hungary
- Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Kálmán Kovács
- National Laboratory on Human Reproduction, 7624 Pécs, Hungary; (K.K.); (E.S.); (Á.V.); (J.B.)
- Department of Obstetrics and Gynecology, University of Pécs, 7624 Pécs, Hungary
- HUN-REN–PTE Human Reproduction Research Group, 7624 Pécs, Hungary
- Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Endre Sulyok
- National Laboratory on Human Reproduction, 7624 Pécs, Hungary; (K.K.); (E.S.); (Á.V.); (J.B.)
- Doctoral School of Health Sciences, University of Pécs, 7624 Pécs, Hungary
| | - Ákos Várnagy
- National Laboratory on Human Reproduction, 7624 Pécs, Hungary; (K.K.); (E.S.); (Á.V.); (J.B.)
- Department of Obstetrics and Gynecology, University of Pécs, 7624 Pécs, Hungary
- HUN-REN–PTE Human Reproduction Research Group, 7624 Pécs, Hungary
- Medical School, University of Pécs, 7624 Pécs, Hungary
| | - József Bódis
- National Laboratory on Human Reproduction, 7624 Pécs, Hungary; (K.K.); (E.S.); (Á.V.); (J.B.)
- Department of Obstetrics and Gynecology, University of Pécs, 7624 Pécs, Hungary
- HUN-REN–PTE Human Reproduction Research Group, 7624 Pécs, Hungary
- Medical School, University of Pécs, 7624 Pécs, Hungary
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Caterino C, Della Valle G, Aragosa F, Cavalli S, Guccione J, Lamagna F, Fatone G. Clinical Application of Platelet Concentrates in Bovine Practice: A Systematic Review. Vet Sci 2023; 10:686. [PMID: 38133237 PMCID: PMC10747389 DOI: 10.3390/vetsci10120686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
Platelet concentrates (PCs) have become widely used in veterinary and human medicine. The PCs consist mainly of supraphysiological concentrations of platelets and, therefore, growth factors (GFs) which are stored within platelet α-granules. Among PCs, Platelet-Rich Plasma (PRP) is characterised by low-density fibrin. Research on the effect of PCs in cattle has surged in recent years; in particular, evidence has shown the positive use of PRP for treating reproductive problems, in vitro production of bovine embryos, sole ulcers and udder diseases. The aim of this report is to critically review, in accordance with the PRISMA guidelines, the available literature reporting clinical application in the bovine practice of PRP. Three bibliographic databases PubMed, Web of Science and Scopus were used for a broad search of "platelet concentrates" OR "PRP" OR "platelet-rich plasma" OR "PRF" OR "platelet-rich fibrin" AND "cows" OR "cattle". From 1196 papers, only six met the inclusion criteria. Two papers described the use of PRP in mastitis, two papers in uterine dysfunction and two papers in ovarian dysfunction. PRP offered a low-cost, easily obtained therapeutic option and showed positive results for these patients. However, given the different pathologies and definitions involved, further studies are necessary to assess its full clinical potential.
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Affiliation(s)
| | | | - Federica Aragosa
- Department of Veterinary Medicine and Animal Production, University of Naples “Federico II”, 80137 Naples, Italy; (C.C.); (G.D.V.); (S.C.); (J.G.); (F.L.); (G.F.)
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Anitua E, Allende M, de la Fuente M, Del Fabbro M, Alkhraisat MH. Efficacy of Platelet-Rich Plasma in Women with a History of Embryo Transfer Failure: A Systematic Review and Meta-Analysis with Trial Sequential Analysis. Bioengineering (Basel) 2023; 10:303. [PMID: 36978694 PMCID: PMC10045363 DOI: 10.3390/bioengineering10030303] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 03/06/2023] Open
Abstract
Assisted reproductive technology (ART) is used to enhance pregnancy in infertile women. In this technique, the eggs are removed from the ovary and fertilized and injected with sperm to make embryos. Unfortunately, embryo implantation failures still occur in many of these women. Platelet-rich plasma (PRP) therapies use a patient's own platelets to promote tissue healing and growth, including endometrium. The growth factors provided by the platelets play a criterial role on the regenerative ability of PRP. In the last years, PRP treatments have been gaining a lot of popularity to treat women with repeated ART failures. In this study, we collected and summarized all information published in the scientific literature to assess the evidence of the PRP effect on pregnancy. We only considered randomized controlled trials (RCT), a type of study designed to be unbiased and considered at the highest level of evidence. Our analysis indicates that PRP therapies might be an effective treatment in cases of poor responsiveness to conventional ART. However, additional studies (well-designed) are necessary to confirm this beneficial effect of PRP.
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Affiliation(s)
- Eduardo Anitua
- Regenerative Medicine Department, BTI Biotechnology Institute, 01007 Vitoria-Gasteiz, Spain
- Clinical Research, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), 01007 Vitoria-Gasteiz, Spain
| | - Mikel Allende
- Regenerative Medicine Department, BTI Biotechnology Institute, 01007 Vitoria-Gasteiz, Spain
- Clinical Research, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), 01007 Vitoria-Gasteiz, Spain
| | - María de la Fuente
- Regenerative Medicine Department, BTI Biotechnology Institute, 01007 Vitoria-Gasteiz, Spain
- Clinical Research, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), 01007 Vitoria-Gasteiz, Spain
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Mohammad Hamdan Alkhraisat
- Regenerative Medicine Department, BTI Biotechnology Institute, 01007 Vitoria-Gasteiz, Spain
- Clinical Research, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), 01007 Vitoria-Gasteiz, Spain
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Li J, Li X, Ding J, Zhao J, Chen J, Guan F, Deng H, Zhou M, Han Y, Xiao Z, Yang J. Analysis of pregnancy outcomes in patients with recurrent implantation failure complicated with chronic endometritis. Front Cell Dev Biol 2023; 11:1088586. [PMID: 36861040 PMCID: PMC9969095 DOI: 10.3389/fcell.2023.1088586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/16/2023] [Indexed: 02/17/2023] Open
Abstract
Chronic endometritis (CE) has been considered to reduce uterine receptivity and negatively affect reproductive outcomes for in vitro fertilization-embryo transfer (IVF-ET) patients, especially for people undergoing recurrent implantation failure (RIF). To investigate the effects of antibiotic and platelet-rich plasma (PRP) therapy on pregnancy outcomes following frozen-thawed embryo transfer (FET) in RIF patients with CE, endometrial specimens of 327 patients with RIF obtained by endometrial scratching during mid-luteal phase were immunostained by multiple myeloma oncogene-1 (Mum-1)/syndecan-1 (CD138). RIF patients with CE were given antibiotics and PRP treatment. According to the Mum-1+/CD138+ plasmacytes after treatment, patients were divided into persistent weak positive CE (+) group, CE (-) group and non-CE group. FET was performed and the basic characteristics and pregnancy outcomes of patients in three groups were compared. Among 327 RIF patients, 117 patients were complicated with CE, the prevalence was 35.78%. The prevalence of strong positive was 27.22% and that of weak positive was 8.56%. 70.94% patients with CE converted to negative after treatment. There was no significant difference in the basic characteristics, including age, BMI, AMH, AFC, infertility years, infertility types, number of previous transplant cycles, endometrial thickness on transplantation day and number of transplanted embryos (p > 0.05); The positive rate of hCG, clinical pregnancy rate and implantation rate in CE (-) group were significantly increased compared with the weak CE (+) group and non-CE group (p < .01), and the live birth rate also improved (p < .05). Whereas, the rate of early abortion in CE (-) group was 12.70%, which was higher than that in weak CE (+) group and non-CE group (p < .05). After multivariate analysis, number of previous failed cycles and CE remained independent factors associated with live birth rate, while only CE remained to be the independent factor of clinical pregnancy rate. It is recommended to perform CE-related examination for patients with RIF. Antibiotic and PRP treatment can significantly improve pregnancy outcomes of patients with CE negative conversion in FET cycle.
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Affiliation(s)
- Jie Li
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xueyao Li
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jinli Ding
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jing Zhao
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jiao Chen
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Feng Guan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Haiyu Deng
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Mengqi Zhou
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yiling Han
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhuoni Xiao
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China,*Correspondence: Jing Yang, ; Zhuoni Xiao,
| | - Jing Yang
- Center for Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan, China,*Correspondence: Jing Yang, ; Zhuoni Xiao,
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Hu S, Jin Z, Tang Q. Effects of Intrauterine Infusion of Autologous Platelet-Rich Plasma in Women Undergoing Treatment with Assisted Reproductive Technology: a Meta-Analysis of Randomized
Controlled Trials. Geburtshilfe Frauenheilkd 2022; 83:453-462. [PMID: 37034414 PMCID: PMC10076096 DOI: 10.1055/a-1963-7459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/16/2022] [Indexed: 12/15/2022] Open
Abstract
Abstract
Purpose This meta-analysis was conducted to systematically retrieve relevant randomized controlled trials (RCTs) and evaluate the effects of intrauterine infusion of
autologous platelet-rich plasma (PRP) in women with thin endometrium, implantation or pregnancy failure undergoing treatment with assisted reproductive technology (ART).
Methods We conducted a systematic review and meta-analysis of the retrieved RCTs. Studies on the intrauterine infusion of PRP in women undergoing treatment with ART that were
published in PubMed, the Cochrane library, Web of Science, and Embase from inception until June 2022 were included. The data were extracted and analyzed independently using the
fixed-effects or random-effects model according to heterogeneity.
Results Seven RCTs involving 861 patients (435 in the intervention group and 426 in the control group) were included. The rates of clinical pregnancy (risk ratio [RR]: 2.51;
95% confidence interval [CI]: 2.0–3.13; P < 0.00001), chemical pregnancy (RR: 1.96; 95% CI: 1.58–2.45; P < 0.00001), live births (RR: 7.03; 95% CI: 3.91–12.6;
P < 0.00001), and implantation (RR: 3.27; 95% CI: 1.42–7.52; P = 0.005) were significantly higher in the women who received PRP infusion than in the control group. No
significant differences were noted in the miscarriage rate (RR: 0.98; 95% CI: 0.39–2.42; P = 0.96) between the two groups.
Conclusion In summary, intrauterine infusion of PRP may be an effective therapy for women with thin endometrium and recurrent implantation failure (RIF) undergoing treatment
with ART. More population-based RCTs are warranted to verify the efficacy of our evidence.
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Affiliation(s)
- Shifu Hu
- Obstetrics and Gynecology Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhishan Jin
- Obstetrics and Gynecology Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qianqian Tang
- Obstetrics and Gynecology Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Abstract
Abstract
Background
The successful use of PRP in regenerative medicine has led investigators to study its effect in the treatment of conditions like decreased ovarian reserve, poor responders, and premature ovarian insufficiency.
Objective
To review the uses of intraovarian PRP in reproductive medicine.
Methods
A literature search for English articles related to the uses of intraovarian PRP in reproductive medicine, including articles published in PubMed, from 2000 to April 2021.
Results
Seventeen studies: No RCT. Studies were classified according to indication. (1) For diminished ovarian reserve: 6 studies including 369 patients. (2). For poor responders: 3 case series studies including 41 patients with an improvement in ovarian response. (3) For premature ovarian insufficiency: 8 studies including 373 patients. Ovarian reserve markers were the outcome of all studies with conflicting results. LBR was not determined in the majority of studies.
Conclusion
Intraovarian PRP for diminished ovarian reserve, poor ovarian response, or POI is still experimental. Well-designed, large RCTS to confirm its efficacy and safety are required.
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Effects of Intraovarian Injection of Autologous Platelet-Rich Plasma on Ovarian Rejuvenation in Poor Responders and Women with Primary Ovarian Insufficiency. Reprod Sci 2021; 28:2050-2059. [PMID: 33683669 DOI: 10.1007/s43032-021-00483-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/31/2021] [Indexed: 12/25/2022]
Abstract
Injection of intraovarian platelet-rich plasma (PRP) was recently presented in terms of improvement ovarian function in women with a poor ovarian response (POR) or primary ovarian insufficiency (POI). In a before and after study, 17 poor responder women and 9 women with the diagnosis of POI were recruited. The multifocal intramedullary infusion of 1.5 ml activated PRP was performed into each ovary. The majority of women in both groups received the second PRP injection with the twofold increase in the dosage to 3ml, 3 months after the first injection. Evaluation of serum anti-mullerian hormone ( AMH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) was performed. In addition, all women were followed with regard to pregnancy outcome up to delivery. In the POI group, menstrual restoration was monitored. The significant difference was not detected regarding the hormonal profile between the three time points in both groups. With regard to pregnancy outcome, 8/17 (47%) of PORs had spontaneous pregnancy in response to PRP injection. Of those, three women (37.55%) had abortions, whereas 4 pregnancies (50%) led to healthy live births, and one woman (12.5%) was in the 24th week of her pregnancy. Menstruation recovery occurred among 22.2% of women with POI after the second PRP injection, but no one became pregnant. Intraovarian injection of autologous PRP might be considered an alternative treatment in poor responders. As for women with POI, it is questionable whether PRP could induce menstrual recovery.
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Hajipour H, Farzadi L, Latifi Z, Keyhanvar N, Navali N, Fattahi A, Nouri M, Dittrich R. An update on platelet-rich plasma (PRP) therapy in endometrium and ovary related infertilities: clinical and molecular aspects. Syst Biol Reprod Med 2021; 67:177-188. [PMID: 33632047 DOI: 10.1080/19396368.2020.1862357] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Administration of platelet-rich plasma (PRP) is one of the well-recommended strategies for the treatment of endometrium- and ovary-associated infertility. Due to the autologous source of PRP, minimal risks for disease transmission and immunogenic and allergic responses are expected in this method. Despite the extensive use of PRP in medicine, its precise mechanism of action in endometrial and ovarian tissues is still unknown. Nevertheless, the induction of cell proliferation, chemotaxis, regeneration, extracellular matrix synthesis, remodeling, angiogenesis, and epithelialization are the main pathways for PRP to affect female reproductive organs. Given the promising results of previous studies, it is necessary to standardize PRP preparation protocols for different therapeutic purposes and also clearly determine appropriate inclusion and exclusion criteria for recruiting patients. In the current review, we presented a summary of studies on PRP therapy for endometrium- and ovary-associated infertility with a focus on the possible mechanisms by which PRP enhances endometrial receptivity and regenerates ovarian function.Abbreviations: PRP: platelet-rich plasma; ART: assisted reproductive technology; POF: premature ovarian failure; TGF: transforming growth factors; PDGF: platelet-derived growth factors; IGF-I: insulin-like growth factor-1; HGF: hepatocyte growth factor; EGF: epidermal growth factor; FGF: fibroblast growth factor; VEGF: vascular endothelial growth factor; ADP: adenosine diphosphate, ATP: adenosine triphosphate; PDGF: platelet-derived growth factor; COX2: cyclooxygenase-2; TP53: tumor protein 53; ER-α: estrogen receptors alpha; ER-β: estrogen receptors beta; PR: progesterone receptor; RIF: recurrent implantation failure; G-CSF: granulocyte colony-stimulating factor; iNOS: inducible nitric oxide synthase; NF-kβ: nuclear factor kappa beta; MMPs: matrix metalloproteinases; Col1a1: collagen type I alpha 1; IL: interleukin; FSH: follicle-stimulating hormone; AMH: anti-Mullerian hormone; GDF-9: growth differentiation factor 9.
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Affiliation(s)
- Hamed Hajipour
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Laya Farzadi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Latifi
- Department of Biochemistry and Clinical Laboratories, Faculty of Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Keyhanvar
- Stem Cell and Regenerative Medicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazli Navali
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Fattahi
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.,OB/GYN, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
| | - Mohammad Nouri
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ralf Dittrich
- OB/GYN, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
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Pourakbari R, Ahmadi H, Yousefi M, Aghebati-Maleki L. Cell therapy in female infertility-related diseases: Emphasis on recurrent miscarriage and repeated implantation failure. Life Sci 2020; 258:118181. [DOI: 10.1016/j.lfs.2020.118181] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/19/2020] [Accepted: 07/28/2020] [Indexed: 12/25/2022]
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Cavalcante MB, Cavalcante CTDMB, Sarno M, Barini R. Intrauterine perfusion immunotherapies in recurrent implantation failures: Systematic review. Am J Reprod Immunol 2020; 83:e13242. [PMID: 32248580 DOI: 10.1111/aji.13242] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 02/06/2023] Open
Abstract
Studies have investigated the gestational outcomes of new immunological therapies in the treatment of patients with recurrent implantation failure (RIF) in assisted reproductive technology (ART). The objective of this article is to assess the current state of evidence available in the literature on intrauterine perfusion immunotherapies in women undergoing ART treatments. By considering the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), the authors performed systematic review by searching the databases of PubMed/MEDLINE and Scopus using the following key words: "recurrent implantation failure," "intrauterine infusion," "Platelet-Rich Plasma (PRP)," "Peripheral Blood Mononuclear Cells (PBMC)," "Granulocyte Colony-Stimulating Factor (G-CSF)," and "Human Chorionic Gonadotropin (hCG)." The authors analyzed the indications and the impact of new immunological therapies with intrauterine infusions on the pregnancy outcomes of patients undergoing ART. PRP, PBMC, G-CSF, and hCG were the four most used immunological therapies with intrauterine infusion. These new therapies appear to improve the results of ART treatments in cases of RIF. However, the small number of studies does not allow definitive conclusions about the effectiveness of these therapies.
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Affiliation(s)
- Marcelo Borges Cavalcante
- Department of Obstetrics and Gynecology, Fortaleza University (UNIFOR), Fortaleza-CE, Brazil.,CONCEPTUS - Reproductive Medicine, Fortaleza-CE, Brazil
| | | | - Manoel Sarno
- Department of Obstetrics and Gynecology, Federal University of Bahia (UFBA), Salvador, Brazil.,Harris Birthright Research Center for Fetal Medicine, King's College Hospital and Department of Fetal Medicine, University College London, London, UK
| | - Ricardo Barini
- Department of Obstetrics and Gynecology, Campinas University (UNICAMP), Campinas, Brazil
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The effect of platelet-rich plasma on the achievement of pregnancy during frozen embryo transfer in women with a history of failed implantation. Heliyon 2020; 6:e03577. [PMID: 32195397 PMCID: PMC7075971 DOI: 10.1016/j.heliyon.2020.e03577] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 11/13/2019] [Accepted: 03/09/2020] [Indexed: 12/23/2022] Open
Abstract
Objective The aim of this study was to evaluate the effect of platelet-rich plasma (PRP) on the rate of implantation and pregnancy in women with repeated failed implantation during frozen embryo transfer. Methods This study was conducted on 50 infertile women candidates (who were referred to the Infertility Treatment Center of Besat Hospital in Sanandaj) with a history of failed implantation for the purpose of frozen embryo transfer. The participants were randomly divided into two groups (n = 25). In the first group (control), the intrauterine infusion of 0.5 ml of Ringer serum was done 48 h before embryo transfer. In the second group (treatment), the intrauterine infusion of 0.5 ml of PRP was performed 48 h before embryo transfer. Results In this study, there was no significant difference between the two groups in the rate of chemical and clinical pregnancy. The rate of chemical pregnancy was 28% in the treatment group and 36% in the control group, while the rate of clinical pregnancy was 28% in the treatment group and 24% in the control group. Conclusion The intrauterine infusion of PRP before frozen embryo transfer in infertile women with a history of failed implantation will not make any significant effect on the result of pregnancy.
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12
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Kim JH, Park M, Paek JY, Lee WS, Song H, Lyu SW. Intrauterine Infusion of Human Platelet-Rich Plasma Improves Endometrial Regeneration and Pregnancy Outcomes in a Murine Model of Asherman's Syndrome. Front Physiol 2020; 11:105. [PMID: 32116803 PMCID: PMC7033504 DOI: 10.3389/fphys.2020.00105] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 01/28/2020] [Indexed: 12/14/2022] Open
Abstract
Asherman’s syndrome (AS) is characterized by intrauterine adhesion or fibrosis resulting from damage to the endometrium, often leading to amenorrhea, infertility, or recurrent pregnancy loss. Although various therapeutic strategies for AS have been proposed, the options remain limited. New strategies such as bone marrow-derived mesenchymal stem cell (BM-MSC) therapy aim to potentiate the intrinsic capacity of endometrial regeneration. However, BM-MSC therapy has not been widely adopted mainly because it involves invasive and expensive procedures such as bone marrow biopsy and cell storing. On the other hand, platelet-rich plasma (PRP) is considered safe and affordable because it involves the less invasive procedure of blood collection from peripheral veins to produce PRP. To assess the effectiveness of human PRP infusion for endometrial regeneration, we established a murine model of injury-induced AS and evaluated endometrial morphology, expression of fibrosis-related factors, implantation sites (IS), and pregnancy outcomes associated with human PRP treatment. We found that treatment with human PRP was associated with improved endometrial morphology, reduced degree of fibrosis, and down-regulated expression of fibrosis-related factors in murine model of AS. Furthermore, human PRP treatment was associated with a higher number of IS and live-births. Our results suggest that human PRP treatment may become a valuable strategy to promote the regeneration of damaged endometrium and thus improve fertility and pregnancy outcomes in clinical practice.
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Affiliation(s)
- Ji Hye Kim
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul, South Korea
| | - Mira Park
- Department of Biomedical Science, CHA University, Seongnam, South Korea
| | - Jin Young Paek
- Department of Laboratory Medicine, CHA Gangnam Medical Center, CHA University, Seoul, South Korea
| | - Woo-Sik Lee
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul, South Korea
| | - Haengseok Song
- Department of Biomedical Science, CHA University, Seongnam, South Korea
| | - Sang Woo Lyu
- Department of Obstetrics and Gynecology, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul, South Korea
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Kim J, Lee J, Jun JH. Identification of differentially expressed microRNAs in outgrowth embryos compared with blastocysts and non-outgrowth embryos in mice. Reprod Fertil Dev 2019; 31:645-657. [PMID: 30428300 DOI: 10.1071/rd18161] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/06/2018] [Indexed: 12/27/2022] Open
Abstract
Recurrent implantation failure (RIF) is one of the main causes for the repeated failure of IVF, and the major reason for RIF is thought to be a miscommunication between the embryo and uterus. However, the exact mechanism underlying embryo-uterus cross-talk is not fully understood. The aim of the present study was to identify differentially expressed microRNAs (miRNAs) among blastocysts, non-outgrowth and outgrowth embryos in mice using microarray analysis. A bioinformatics analysis was performed to predict the potential mechanisms of implantation. The miRNA expression profiles differed significantly between non-outgrowth and outgrowth embryos. In all, 3163 miRNAs were detected in blastocysts and outgrowth embryos. Of these, 10 miRNA candidates (let-7b, miR-23a, miR-27a, miR-92a, miR-183, miR-200c, miR-291a, miR-425, miR-429 and miR-652) were identified as significant differentially expressed miRNAs of outgrowth embryos by in silico analysis. The expression of the miRNA candidates was markedly changed during preimplantation embryo development. In particular, let-7b-5p, miR-200c-3p and miR-23a-3p were significantly upregulated in outgrowth embryos compared with non-outgrowth blastocysts. Overall, differentially expressed miRNAs in outgrowth embryos compared with blastocysts and non-outgrowth embryos could be involved in embryo attachment, and interaction between the embryo proper and maternal endometrium during the implantation process.
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Affiliation(s)
- Jihyun Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Jaewang Lee
- Department of Biomedical Laboratory Science, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13135, Republic of Korea
| | - Jin Hyun Jun
- Department of Biomedical Laboratory Science, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do 13135, Republic of Korea
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14
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Coksuer H, Akdemir Y, Ulas 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; 35:815-818. [PMID: 30966843 DOI: 10.1080/09513590.2019.1597344] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Repeated implantation failure (RIF) due to suboptimal endometrial lining is a major challenge in reproductive medicine. The study aims to evaluate effect of intrauterine platelet-rich plasma (PRP) treatment on frozen-thawed embryo transfer (FET) cycles in patients whose endometrium was unable to achieve optimal lining in unexplained infertility patients with history of RIF. We retrospectively analyzed the charts of a total of 302 cycles performed in 273 patients attending Diyar Life ART Centre between January 2014 and January 2017. After excluding 232 cycles, we compared pregnancy outcomes of 34 patients who had suboptimal endometrial lining and underwent PRP + FET and 36 patients who had optimal endometrial lining and underwent only FET. We observed that, endometrial thickness was higher after 48 hours from PRP when compared to endometrial thickness before PRP (10 mm vs. 6.25 mm, p < .001). Clinical pregnancy rate, and importantly live birth rate were also significantly higher in PRP group than the control group. Based on this information, we showed that intrauterine autologous PRP infusion is a safe, inexpensive adjuvant treatment for optimizing endometrium especially in patients with RIF history and intrauterine PRP infusion improved not only endometrial lining but also in vitro fertilization success and pregnancy outcome.
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Affiliation(s)
- Hakan Coksuer
- a Obstetrics and Gynecology Department, Diyarlife IVF Center , Diyarbakır , Turkey
| | - Yesim Akdemir
- b Obstetrics and Gynecology Department, Bulent Ecevit University School of Medicine , Zonguldak , Turkey
| | - Mert Ulas Barut
- c Department of Obstetrics and Gynecology, Harran University School of Medicine , Sanlıurfa , Turkey
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15
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Bos-Mikich A, Ferreira MO, de Oliveira R, Frantz N. Platelet-rich plasma or blood-derived products to improve endometrial receptivity? J Assist Reprod Genet 2019; 36:613-620. [PMID: 30610660 PMCID: PMC6504981 DOI: 10.1007/s10815-018-1386-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 12/14/2018] [Indexed: 02/07/2023] Open
Abstract
The use of platelet-rich plasma (PRP) to improve endometrial receptivity is gaining increasing attention in assisted reproduction technologies. The authors report that autologous PRP intrauterine administration improves pregnancy and birth rates, particularly in cases of patients presenting poor endometrial growth. Different groups of scientists proposed a similar approach years ago using whole blood-derived products also to improve endometrial receptivity. The important role played by cytokines and growth factors during embryo implantation has been well-known for a long time. These signaling molecules are present and released by blood cells during physiological, normal endometrial growth and implantation. Similar blood mediators are released from platelet granules upon a blood vessel injury. Methods described for PRP preparation for intrauterine administration are not precise, and they seem to be similar to those used to prepare peripheral blood-derived products. Thus, it is possible that when preparing PRP from whole blood, the final plasma product used as "PRP" contains platelets in addition to the important cytokines and growth factors released by the peripheral blood mononuclear cells present in the whole blood. Precise knowledge of the identity, concentration, and effects of the individual blood factors, their origin, whether platelets or blood mononuclear cells, will greatly contribute to improve and to make results obtained in fertility treatments more repeatable.
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Affiliation(s)
- Adriana Bos-Mikich
- Department of Morphological Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | | | | | - Nilo Frantz
- nilo.frantz Medicina Reprodutiva, Porto Alegre, RS, Brazil
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16
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A report on three live births in women with poor ovarian response following intra-ovarian injection of platelet-rich plasma (PRP). Mol Biol Rep 2019; 46:1611-1616. [DOI: 10.1007/s11033-019-04609-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/16/2019] [Indexed: 11/27/2022]
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