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Qi J, Li X, Cao Y, Long Y, Lai J, Yao Y, Meng Y, Wang Y, Chen XD, Vankelecom H, Bian X, Cui W, Sun Y. Locationally activated PRP via an injectable dual-network hydrogel for endometrial regeneration. Biomaterials 2024; 309:122615. [PMID: 38759486 DOI: 10.1016/j.biomaterials.2024.122615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 04/29/2024] [Accepted: 05/10/2024] [Indexed: 05/19/2024]
Abstract
Enhancing the effectiveness of platelet-rich plasma (PRP) for endometrial regeneration is challenging, due to its limited mechanical properties and burst release of growth factors. Here, we proposed an injectable interpenetrating dual-network hydrogel that can locationally activate PRP within the uterine cavity, sustained release growth factors and further address the insufficient therapeutic efficacy. Locational activation of PRP is achieved using the dual-network hydrogel. The phenylboronic acid (PBA) modified methacrylated hyaluronic acid (HAMA) dispersion chelates Ca2+ by carboxy groups and polyphenol groups, and in situ crosslinked with PRP-loaded polyvinyl alcohol (PVA) dispersion by dynamic borate ester bonds thus establishing the soft hydrogel. Subsequently, in situ photo-crosslinking technology is employed to enhance the mechanical performance of hydrogels by initiating free radical polymerization of carbon-carbon double bonds to form a dense network. The PRP-hydrogel significantly promoted the endometrial cell proliferation, exhibited strong pro-angiogenic effects, and down-regulated the expression of collagen deposition genes by inhibiting the TGF-β1-SMAD2/3 pathway in vitro. In vivo experiments using a rat intrauterine adhesion (IUA) model showed that the PRP-hydrogel significantly promoted endometrial regeneration and restored uterine functionality. Furthermore, rats treated with the PRP-hydrogel displayed an increase in the number of embryos, litter size, and birth rate, which was similar to normal rats. Overall, this injectable interpenetrating dual-network hydrogel, capable of locational activation of PRP, suggests a new therapeutic approach for endometrial repair.
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Affiliation(s)
- Jia Qi
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiaoxiao Li
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Laboratory of Key Technology and Materials in Minimally Invasive Spine Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yumeng Cao
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yijing Long
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Junliang Lai
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yejie Yao
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yiwen Meng
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yuan Wang
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xiao-Dong Chen
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, Research Service, South Texas Veterans Health Care System, Audie Murphy VA Medical Center, San Antonio, TX, 78229, USA
| | - Hugo Vankelecom
- Department of Development and Regeneration, Cluster Stem Cell Biology and Embryology, Research Unit of Stem Cell Research, University of Leuven (KU Leuven), B-3000, Leuven, Belgium
| | - Xuejiao Bian
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China; Department of Development and Regeneration, Cluster Stem Cell Biology and Embryology, Research Unit of Stem Cell Research, University of Leuven (KU Leuven), B-3000, Leuven, Belgium
| | - Wenguo Cui
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Yun Sun
- Department of Reproductive Medicine, Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Liu X, Qian C, Jiang X, Zhou Y, Feng X, Ding Y, Jin J, Hu M, Zhou W, Liu B, Zhou H. Efficacy of platelet-rich plasma in the treatment of thin endometrium: a meta-analysis of randomized controlled trials. BMC Pregnancy Childbirth 2024; 24:567. [PMID: 39215227 PMCID: PMC11363443 DOI: 10.1186/s12884-024-06741-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 08/06/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Thin endometrium (TE) is a common cause of female infertility in clinical practice. Platelet-rich Plasma (PRP) therapy becomes a novel treatment for thin endometrium; however, its clinical application remains controversial. This meta-analysis aims to evaluate the therapeutic effects of intrauterine autologous PRP infusion in women with thin endometrium through relevant randomized controlled trials (RCTs). METHODS We systematically searched studies published in English from inception until June 2024 in databases such as PubMed, The Cochrane Library, Embase, Web of Science, and MEDLINE. Search terms included "Platelet-Rich Plasma," "thin endometrium," "endometrial thickness," "infertility," "pregnancy," "reproduction," and "adverse reactions". RCTs identified through the search were subjected to systematic review and meta-analysis, and data were analyzed using fixed-effects or random-effects models based on heterogeneity. RESULTS Eight RCTs involving 678 patients with thin endometrium were included. Patients receiving PRP infusion demonstrated significantly superior outcomes compared to the control group in endometrial thickness (MD: 1.23, 95%CI: 0.87 to 1.59, P = 0.000), clinical pregnancy rate (RR: 2.04, 95%CI: 1.52 to 2.76, P = 0.000), live birth rate (RR: 2.46; 95%CI: 1.57 to 3.85, P = 0.000), cycle cancellation rate (RR: 0.46, 95%CI: 0.23 to 0.93, P = 0.000), and embryo implantation rate (RR: 2.71; 95%CI: 1.91 to 3.84, P = 0.000). There were no statistically significance in spontaneous abortion rate (RR: 0.85, 95%CI: 0.40 to 1.78, P = 0.659), chemical pregnancy rate (RR: 1.84, 95%CI: 0.72 to 4.72, P = 0.204) and endometrial vascular improvement rate (RR: 1.10; 95%CI: 0.89 to 1.38, P = 0.367) between the two groups. The limitations of this study includes that, we only included single lauguage for literature research, the sample size and heterogeneity which could cause criteria bias. CONCLUSION Intrauterine PRP infusion may be an effective and safe treatment for women with thin endometrium. Further high-quality, large-sample, randomized controlled trials are needed to validate the reliability of our results. TRIAL REGISTRATION The review protocol is registered on PROSPERO with registration number CRD42023490421, and no modifications were made to the information provided at registration.
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Affiliation(s)
- Xinyuan Liu
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing, Jiangsu, China
| | - Chengyu Qian
- Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaoyue Jiang
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing, Jiangsu, China
| | - Yue Zhou
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing, Jiangsu, China
| | - Xue Feng
- Shandong Tai'an Hospital of Traditional Chinese Medicine, Tai'an, 271000, Shandong, China
| | - Yinyin Ding
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing, Jiangsu, China
| | - Jing Jin
- Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing, Jiangsu, China
| | - Minghui Hu
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Weiye Zhou
- Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing, Jiangsu, China
| | - Bei Liu
- Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing, Jiangsu, China
| | - Huifang Zhou
- Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Traditional Chinese Medicine), Nanjing, Jiangsu, China.
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Serdarogullari M, Raad G, Makieva S, Liperis G, Fraire-Zamora JJ, Celik-Ozenci C. Revitalizing female fertility: platelet-rich plasma - hype or hope? Reprod Biomed Online 2024; 49:103813. [PMID: 38852205 DOI: 10.1016/j.rbmo.2024.103813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 06/11/2024]
Abstract
Platelet-rich plasma (PRP) has gained popularity as an experimental tool in regenerative medicine, with potential applications in reproductive medicine. This review will assess the existing literature on the role of PRP in female fertility enhancement, focusing on ovarian rejuvenation and increased endometrial thickness. PRP is being explored as a treatment for recurrent implantation failure, primary ovarian insufficiency and poor ovarian response. While the influence of PRP on endometrial thickness and implantation success is postulated, its effectiveness remains the subject of debate due to protocol variability and unclear patient selection criteria. This narrative review includes 36 articles published before December 2022, and highlights the lack of comprehensive molecular studies examining the impact of PRP on reproductive capacity. This review underscores the importance of standardizing PRP preparation protocols in reproductive medicine. However, challenges persist, and there is a need for well-planned randomized controlled trials and a deeper understanding of the patient population that would gain the greatest benefit from PRP treatment. Clarifying these aspects is crucial to improve outcomes for low-prognosis patients undergoing assisted reproductive technology.
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Affiliation(s)
- Munevver Serdarogullari
- Department of Histology and Embryology, Faculty of Medicine, Cyprus International University, Northern Cyprus via Mersin 10, Turkey
| | - Georges Raad
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon; Al Hadi Laboratory and Medical Centre, Beirut, Lebanon
| | - Sofia Makieva
- Kinderwunschzentrum, Klinik für Reproduktions-Endokrinologie, Universitätsspital Zürich, Zurich, Switzerland
| | - Georgios Liperis
- Westmead Fertility Centre, Institute of Reproductive Medicine, University of Sydney, Westmead, NSW, Australia
| | | | - Ciler Celik-Ozenci
- Department of Histology and Embryology, School of Medicine, Koc University, Istanbul, Turkey; Koç University Research Centre for Translational Medicine, Istanbul, Turkey.
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Shaikh JS, More A, Nair N, Shrivastava J, Pareek C. A Successful Pregnancy Outcome Using Laser-Assisted Hatching and Platelet-Rich Plasma Perfusion in Advanced Maternal and Paternal Age: A Case Report. Cureus 2024; 16:e63926. [PMID: 39105032 PMCID: PMC11298565 DOI: 10.7759/cureus.63926] [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: 05/24/2024] [Accepted: 07/05/2024] [Indexed: 08/07/2024] Open
Abstract
Infertility affects millions globally, with advanced parental age posing a significant risk. This case report details a couple who experienced secondary infertility for 12 years. Following multiple unsuccessful attempts at assisted reproductive technology (ART), a personalized treatment regimen involving platelet-rich plasma (PRP) perfusion and laser-assisted hatching (LAH) resulted in a successful pregnancy. Diagnostic evaluations identified specific reproductive challenges, leading to tailored interventions. A positive pregnancy outcome was achieved after PRP treatment enhanced endometrial thickness and LAH facilitated embryo implantation. This case highlights the importance of individualized treatment strategies in infertility management and proves the potential efficacy of PRP and LAH in overcoming recurrent implantation failure. Further research is needed to explain the roles of PRP and LAH in improving pregnancy outcomes, especially in older parents and couples with a history of failed in vitro fertilization (IVF) treatments.
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Affiliation(s)
- Jafar S Shaikh
- Clinical Embryology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Akash More
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nancy Nair
- Clinical Embryology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Jarul Shrivastava
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Charu Pareek
- Clinical Embryology, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
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5
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Karadbhajne P, More A, Dzoagbe HY. Enhancing Endometrial Health in Assisted Reproductive Technology (ART): Evaluating Autologous Endometrial Cells and Platelets-Rich Plasma (PRP) via Hysteroscopic Injections. Cureus 2024; 16:e64068. [PMID: 39114217 PMCID: PMC11305442 DOI: 10.7759/cureus.64068] [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: 06/14/2024] [Accepted: 07/08/2024] [Indexed: 08/10/2024] Open
Abstract
This review article examines the effectiveness of incorporating autologous endometrial cells and platelet-rich plasma (PRP) through hysteroscopic injections within the field of assisted reproductive technology (ART). This study assesses the outcomes of these injections on the susceptibility of the endometrium, the dynamics of the uterus, and the frequencies of pregnancy in individuals with refractory thin endometrium. Based on a complete examination of several trials, it becomes apparent that autologous PRP injections provide encouraging turnouts in augmenting endometrial thickness, raising endometrial receptivity, and, in the end, raising chances of being pregnant and successful delivery. The research highlights the promise of autologous PRP and minimally changed endometrial cellular treatments in enhancing outcomes in ART, especially for people who have had problems with implantation. This article gives a whole evaluation of the medical use of and upgrades regarding the utilization of infusions of PRP and autologous endometrial cells under hysteroscopic control to deal with infertility issues related to endometrial health through the synthesis of contemporary studies.
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Affiliation(s)
- Priti Karadbhajne
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Akash More
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Hellen Y Dzoagbe
- Obstetrics and Gynecology, Acharya Vinoba Bhave Rural Hospital, Wardha, IND
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6
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Karadbhajne P, Dzoagbe HY, More A. Platelet-Rich Plasma (PRP) for Endometrial Treatment Efficacy and Safety in Assisted Reproductive Technology: A Comprehensive Review. Cureus 2024; 16:e59728. [PMID: 38841044 PMCID: PMC11151180 DOI: 10.7759/cureus.59728] [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: 03/24/2024] [Accepted: 05/05/2024] [Indexed: 06/07/2024] Open
Abstract
Platelet-rich plasma (PRP) is among the new ground-breaking methods called for endometrial disorders detected in assisted reproductive technology (ART). This research work takes account of both a systematic literature review and an exploration of the molecular connections. The report aims to present the capabilities and benefits of the PRP in ART and the nonconformance and dangers involved in its use in ART. However, all these stages of ART need conducive endometrium, live micro embryo, and coordinated interaction between the blastocyst and the uterus. Despite all ART has achieved, implantation failure still exists as a problem having one quarter being attributed to the absence of the endometrial receptivity level. The review points to a corresponding increase in the role of autologous PRP in promoting cell proliferation, neo-angiogenesis, and anti-inflammatory effects to facilitate effective endometrial receptivity. The outcome of prior trials with the PRP approach proved to be positive for women with adenomyosis, thin endometrial lining, recurring implantation failure, chronic endometritis, and Asherman's syndrome. Challenges still exist in the proper placement of PRP for all women with infertility problems as well as how it works for individuals with blood disorders and infections. This study will look into the safest number of doses, the time of acting, and the possible future health hazards that both mother and child may face.
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Affiliation(s)
- Priti Karadbhajne
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Hellen Y Dzoagbe
- Pharmacy, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Nursing, Public Health Nurses' School, Accra, GHA
| | - Akash More
- Clinical Embryology, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Zhang JC, Zhang HL, Xin XY, Zhu YT, Mao X, Hu HQ, Jin YX, Fan RW, Zhang XH, Ye Y, Li D. Mechanisms of Bushen Tiaoxue Granules against controlled ovarian hyperstimulation-induced abnormal morphology of endometrium based on network pharmacology. J Ovarian Res 2024; 17:25. [PMID: 38279186 PMCID: PMC10811918 DOI: 10.1186/s13048-023-01339-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 12/30/2023] [Indexed: 01/28/2024] Open
Abstract
Bushen Tiaoxue Granules (BTG) is an empirical Chinese herbal formula that has been used for the treatment of subfertility. The protective effect of BTG on controlled ovarian hyperstimulation (COH)-induced impaired endometrial receptivity has been reported in our previous study. This study aims to explore the mechanisms of BTG on ameliorating abnormal morphology of endometrium based on network pharmacology. Active compounds of BTG were identified via the traditional Chinese medicine systems pharmacology and UPLC-MS technology. The SwissTargetPrediction platform and HERB database were used to screen out the putative targets of BTG. Potential targets of endometrial dysfunction caused by COH were obtained from three GEO databases. Through the STRING database, the protein-protein interaction was carried out according to the cross-common targets of diseases and drugs. GO terms and KEGG pathways enrichment analyses were conducted via the Metascape database. AutoDock Vina was used for docking validation of the affinity between active compounds and potential targets. Finally, in vivo experiments were used to verify the potential mechanisms derived from network pharmacology study. A total of 141 effective ingredients were obtained from TCMSP and nine of which were verified in UPLC-MS. Six genes were selected through the intersection of 534 disease related genes and 165 drug potential targets. Enrichment analyses showed that BTG might reverse endometrial dysfunction by regulating adherens junction and arachidonic acid metabolism. Hematoxylin-eosin staining revealed that BTG ameliorated the loose and edematous status of endometrial epithelium caused by COH. The protein expression of FOXO1A, β-Catenin and COX-2 was decreased in the COH group, and was up-regulated by BTG. BTG significantly alleviates the edema of endometrial epithelium caused by COH. The mechanisms may be related to adheren junctions and activation of arachidonic acid metabolism. The potential active compounds quercetin, taxifolin, kaempferol, eriodictyol, and isorhamnetin identified from the BTG exhibit marginal cytotoxicity. Both high and low concentrations of kaempferol, eriodictyol, and taxifolin are capable of effectively ameliorating impaired hESC cellular activity.
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Affiliation(s)
- Jia-Cheng Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Hao-Lin Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Xi-Yan Xin
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yu-Tian Zhu
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Xin Mao
- Department of Radiology, Peking University Third Hospital, Beijing, China
| | - Hang-Qi Hu
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yu-Xin Jin
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Rui-Wen Fan
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Xiao-Hui Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yang Ye
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China.
| | - Dong Li
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China.
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Li X, Liu H, Lin G, Xu L. The effect of ovarian injection of autologous platelet rich plasma in patients with poor ovarian responder: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1292168. [PMID: 38155954 PMCID: PMC10754527 DOI: 10.3389/fendo.2023.1292168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Objective To evaluate the effects of ovarian injection of autologous platelet rich plasma (aPRP) on patients with poor ovarian responder (POR) based on the existing clinical evidence. Methods According to systematic review and meta-analysis, we comprehensively searched nine databases established as of September 6, 2023, and evaluated the impact of ovarian PRP infusion on poor ovarian responder. The research results include serum follicle-stimulating hormone(FSH) and anti-Mullerian hormone(AMH) levels, antral Follicle Count(AFC), oocyte number, and embryo number. The Newcastle Ottawa Scale (NOS) was used to evaluate the quality of inclusion in trials. Results Add up to 10 studies consisting of 793 participants were included in the meta-analysis. A review of existing evidence showed that intraovarian injection of PRP has significant therapeutic effects in increasing levels of anti-Müllerian hormone (AMH) (SMD=0.44,95% CI [0.07,0.81], p=0.02), antral follicle count (AFC) (MD=1.15,95% CI [0.4,1.90], p=0.003), oocyte count (MD=0.91, 95% CI [0.40, 1.41], p=0.0004), and embryo number (MD=0.78, 95% CI [0.5,1.07], p<0.0001). We compared the relevant data of patients before and after treatment after 2 months of intervention. It can be seen that ovarian injection of PRP treatment for 2 months has better effects in reducing FSH levels, increasing AMH levels, increasing antral follicle count, and increasing the number of oocytes and embryos (p<0.05). When the dose of PRP injected into each ovary was ≥ 4ml, there was also a significant correlation (p<0.05) with improving the number of AFC, oocytes and embryos. Significant heterogeneity existed among the studies. Conclusion The pooled results suggest that intra-ovarian injection of PRP can promote ovarian regeneration and improve the reproductive outcomes of patients with ovarian dysfunction. This therapy may have significant clinical potential in improving sex hormone levels, increasing AFC, oocyte count, and embryo count. However, this findings still requires more rigorous and extensive trials worldwide to determine the value of intra-ovarian injection of PRP in POR patients. Systematic review registration https://www.crd.york.ac.uk, Identifier CRD42023451232.
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Affiliation(s)
| | | | | | - Lianwei Xu
- Department of Gynecology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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9
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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: 0] [Impact Index Per Article: 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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Li CJ, Zhan YD, Zhou XL, Yang J, Deng L, Li XL, Chen X. Value of Intrauterine Autologous Platelet-Rich Plasma Therapy on Endometrial Receptivity: A Literature Review. Curr Med Sci 2023; 43:1075-1083. [PMID: 38041791 DOI: 10.1007/s11596-023-2816-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/16/2023] [Indexed: 12/03/2023]
Abstract
Endometrial receptivity is an important factor that influences embryo implantation. Thus, it is important to identify an applicable approach to improve endometrial receptivity in women undergoing assisted reproductive technology. Recently, growing evidence has indicated that intrauterine platelet-rich plasma (PRP) infusion is an effective method to obtain a satisfactory reproductive outcome by increasing endometrial thickness and improving endometrial receptivity. Therefore, the present review aims to outline the possible mechanisms of PRP on endometrial receptivity and summarize the present literature on the effects of PRP therapy in improving endometrial receptivity.
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Affiliation(s)
- Chu-Jun Li
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Shunde, 528300, China
| | - Ya-Dou Zhan
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Shunde, 528300, China
| | - Xian-Li Zhou
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Shunde, 528300, China
| | - Jie Yang
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Shunde, 528300, China
| | - Ling Deng
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Shunde, 528300, China
| | - Xue-Lan Li
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Shunde, 528300, China.
| | - Xin Chen
- Reproductive Medicine Center, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Shunde, 528300, China.
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11
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Lin PY, Lee CI, Chen YC, Cheng EH, Huang CC, Chen CI, Lee TH, Lee YJ, Lee MS. Factors Affecting the Potential Efficacy of Intrauterine Platelet-Rich Plasma Infusion on Thin Endometrium in Women with Recurrent Implantation Failure. J Pers Med 2023; 13:1419. [PMID: 37763186 PMCID: PMC10532920 DOI: 10.3390/jpm13091419] [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: 08/04/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Optimizing endometrial thickness (EMT) is crucial for successful embryo implantation, but enhancing thin endometrium remains a significant challenge. Platelet-rich plasma (PRP)-derived therapies have emerged as a promising approach in reproductive medicine due to their capacity to facilitate tissue repair and regeneration. This study aims to identify the risk factors associated with the failure of intrauterine PRP infusion for thin endometrium in women with recurrent implantation failure (RIF). We retrospectively reviewed data from 77 women with RIF, all exhibiting an EMT of <7 mm. These women underwent programmed hormone therapy for frozen embryo transfer (FET) and received two autologous intrauterine PRP infusions. Following intrauterine PRP-lysate (PL) infusions, the mean increase in EMT was 1.9 ± 1.2 mm, with EMT reaching 7 mm in 86% of the cases (66/77; average EMT, 8.3 mm). We identified an exceedingly thin EMT as a risk factor impacting the therapeutic efficacy in increasing EMT (p = 0.04, OR: 3.16; 95% CI: 1.03-9.67). Additionally, the number of previous uterine surgeries emerged as a prognostic factor for pregnancy failure following PL infusion (p = 0.02, OR: 2.02; 95% CI: 1.12-3.64). Our findings suggest that an extremely thin EMT and a history of numerous uterine surgeries can impede successful pregnancy, even when an optimal EMT is achieved following PRP infusion.
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Affiliation(s)
- Pin-Yao Lin
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Chun-I Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
| | - Yi-Chun Chen
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - En-Hui Cheng
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Chun-Chia Huang
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Chung-I Chen
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Tsung-Hsien Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
| | - Yu-Jen Lee
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
| | - Maw-Sheng Lee
- Institute of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan; (P.-Y.L.)
- Division of Infertility, Lee Women’s Hospital, No. 30-6, Sec. 1, Changping Road, Beitun District, Taichung City 406, Taiwan (Y.-J.L.)
- Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan
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12
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Mrozikiewicz AE, Kurzawińska G, Ożarowski M, Walczak M, Ożegowska K, Jędrzejczak P. Polymorphic Variants of Genes Encoding Angiogenesis-Related Factors in Infertile Women with Recurrent Implantation Failure. Int J Mol Sci 2023; 24:ijms24054267. [PMID: 36901702 PMCID: PMC10001634 DOI: 10.3390/ijms24054267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/14/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023] Open
Abstract
Recurrent implantation failure (RIF) is a global health issue affecting a significant number of infertile women who undergo in vitro fertilization (IVF) cycles. Extensive vasculogenesis and angiogenesis occur in both maternal and fetal placental tissues, and vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF) family molecules and their receptors are potent angiogenic mediators in the placenta. Five single nucleotide polymorphisms (SNPs) in the genes encoding angiogenesis-related factors were selected and genotyped in 247 women who had undergone the ART procedure and 120 healthy controls. Genotyping was conducted by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). A variant of the kinase insertion domain receptor (KDR) gene (rs2071559) was associated with an increased risk of infertility after adjusting for age and BMI (OR = 0.64; 95% CI: 0.45-0.91, p = 0.013 in a log-additive model). Vascular endothelial growth factor A (VEGFA) rs699947 was associated with an increased risk of recurrent implantation failures under a dominant (OR = 2.34; 95% CI: 1.11-4.94, padj. = 0.022) and a log-additive model (OR = 0.65; 95% CI 0.43-0.99, padj. = 0.038). Variants of the KDR gene (rs1870377, rs2071559) in the whole group were in linkage equilibrium (D' = 0.25, r2 = 0.025). Gene-gene interaction analysis showed the strongest interactions between the KDR gene SNPs rs2071559-rs1870377 (p = 0.004) and KDR rs1870377-VEGFA rs699947 (p = 0.030). Our study revealed that the KDR gene rs2071559 variant may be associated with infertility and rs699947 VEGFA with an increased risk of recurrent implantation failures in infertile ART treated Polish women.
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Affiliation(s)
- Aleksandra E. Mrozikiewicz
- Department of Obstetrics and Women’s Diseases, Poznan University of Medical Sciences, Polna 33, 60-535 Poznan, Poland
- Chair and Department of Cell Biology, Poznan University of Medical Sciences, Rokietnicka 5D, 60-806 Poznan, Poland
| | - Grażyna Kurzawińska
- Division of Perinatology and Womens Diseases, Poznan University of Medical Sciences, Polna 33, 60-535 Poznan, Poland
| | - Marcin Ożarowski
- Department of Biotechnology, Institute of Natural Fibres and Medicinal Plants—National Research Institute, Wojska Polskiego 71B, 60-630 Poznan, Poland
- Correspondence:
| | - Michał Walczak
- Institute of Human Genetics, Polish Academy of Sciences, Strzeszyńska 32, 60-479 Poznan, Poland
| | - Katarzyna Ożegowska
- Department of Infertility and Reproductive Endocrinology, Poznan University of Medical Sciences, Polna 33, 60-535 Poznan, Poland
| | - Piotr Jędrzejczak
- Chair and Department of Cell Biology, Poznan University of Medical Sciences, Rokietnicka 5D, 60-806 Poznan, Poland
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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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Tesarik J, Mendoza-Tesarik R. Molecular Clues to Understanding Causes of Human-Assisted Reproduction Treatment Failures and Possible Treatment Options. Int J Mol Sci 2022; 23:10357. [PMID: 36142268 PMCID: PMC9499616 DOI: 10.3390/ijms231810357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 11/16/2022] Open
Abstract
More than forty years after the first birth following in vitro fertilization (IVF), the success rates of IVF and of IVF-derived assisted reproduction techniques (ART) still remain relatively low. Interindividual differences between infertile couples and the nature of the problems underlying their infertility appear to be underestimated nowadays. Consequently, the molecular basis of each couple's reproductive function and of its disturbances is needed to offer an individualized diagnostic and therapeutic approaches to each couple, instead of applying a standard or minimally adapted protocols to everybody. Interindividual differences include sperm and oocyte function and health status, early (preimplantation) embryonic development, the optimal window of uterine receptivity for the implanting embryo, the function of the corpus luteum as the main source of progesterone production during the first days of pregnancy, the timing of the subsequent luteoplacental shift in progesterone production, and aberrant reactions of the uterine immune cells to the implanting and recently implanted embryos. In this article, the molecular basis that underlies each of these abnormalities is reviewed and discussed, with the aim to design specific treatment options to be used for each of them.
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15
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Kheil MH, Bahsoun R, Sharara FI. Platelet-rich plasma: inconclusive evidence of reproductive outcomes in menopausal women. J Assist Reprod Genet 2022; 39:1987-1991. [PMID: 35731320 PMCID: PMC9474992 DOI: 10.1007/s10815-022-02554-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE The use of platelet-rich plasma is being investigated in reproductive medicine and clinically promoted as a fertility treatment for menopause. We aimed to review the literature on the impact of PRP on fertility in menopause. METHODS A literature search was performed using the PubMed and MEDLINE search engines. The search was limited to the English language. Articles studying PRP use in menopause were selected for the purpose of this review. RESULTS Limited case reports and case series studied fertility outcomes of PRP in menopause. Randomized controlled trials are lacking. Furthermore, no studies have been conducted to evaluate the effect of different PRP concentrations, injection techniques, or side effects on reproductive outcomes in menopausal women. CONCLUSION There is a dearth of data to support the routine implementation of intraovarian PRP injections for fertility restoration in menopausal women. Patients considering such therapy need to be well aware of the lack of adequate data for PRP use in menopause and should be counseled accordingly.
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Affiliation(s)
- Mira H Kheil
- Department of Pathology, Wayne State University, Detroit, MI, USA
| | - Reem Bahsoun
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Fady I Sharara
- Virginia Center for Reproductive Medicine, 11150 Sunset Hills Rd., Suite 100, Reston, VA, 20190, USA.
- Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC, USA.
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16
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Silviu‐Ionuț B, Ibănescu I, Alina V, Abdoon AS. Platelet‐rich Plasma in Animal Reproductive Medicine: Prospective and Applications. Reprod Domest Anim 2022; 57:1287-1294. [DOI: 10.1111/rda.14213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Borş Silviu‐Ionuț
- Research and Development Station for Cattle Breeding, Romanian Academy of Science, 707252 Dancu, Iaşi Romania
| | | | - Vlad‐Sabie Alina
- Department of Public Health, Faculty of Veterinary Medicine University of Life Sciences “Ion Ionescu de la Brad” Iaşi 700490 Iasi Romania
| | - Ahmed Sabry Abdoon
- Department of Animal Reproduction and Artificial Insemination Veterinary Research Institute National Research Centre, Dokki 12622 Cairo Egypt
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17
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Endometrial scratching: less invasive methods should be tried first. Reprod Biomed Online 2022; 45:417. [DOI: 10.1016/j.rbmo.2022.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 05/16/2022] [Indexed: 11/22/2022]
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18
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Liu R, Dai M, Gong G, Chen M, Cao C, Wang T, Hou Z, Shi Y, Guo J, Zhang Y, Xia X. The role of extracellular matrix on unfavorable maternal–fetal interface: focusing on the function of collagen in human fertility. JOURNAL OF LEATHER SCIENCE AND ENGINEERING 2022. [DOI: 10.1186/s42825-022-00087-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AbstractExtracellular matrix (ECM) is characterized as widespread, abundant, and pluripotent. Among ECM members, collagen is widely accepted as one of the most prominent components for its essential structural property that can provide a scaffold for other components of ECM and the rich biological functions, which has been extensively used in tissue engineering. Emerging evidence has shown that the balance of ECM degradation and remodeling is vital to regulations of maternal–fetal interface including menstrual cycling, decidualization, embryo implantation and pregnancy maintenance. Moreover, disorders in these events may eventually lead to failure of pregnancy. Although the improvement of assisted conception and embryo culture technologies bring hope to many infertile couples, some unfavorable outcomes, such as recurrent implantation failure (RIF), recurrent pregnancy loss (RPL) or recurrent miscarriage (RM), keep troubling the clinicians and patients. Recently, in vitro three-dimensional (3D) model mimicking the microenvironment of the maternal–fetal interface is developed to investigate the physiological and pathological conditions of conception and pregnancy. The progress of this technology is based on clarifying the role of ECM in the endometrium and the interaction between endometrium and conceptus. Focusing on collagen, the present review summarized the degradation and regulation of ECM and its role in normal menstruation, endometrium receptivity and unsatisfying events occurring in infertility treatments, as well as the application in therapeutic approaches to improve pregnancy outcomes. More investigations about ECM focusing on the maternal–fetal interface interaction with mesenchymal stem cells or local immunoregulation may inspire new thoughts and advancements in the clinical application of infertility treatments.
Graphical abstract
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