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富血小板血浆治疗薄型子宫内膜的疗效与安全性:一项系统评价与荟萃分析方案

Efficacy and safety of platelet-rich plasma for the treatment of thin endometrium: A protocol for systematic review and meta-analysis.

作者信息

Du Juan, Lu Hua, Yu Xujun, Lü Zili, Mi Ling, Zhang Xiaojin

机构信息

Hospital of Chengdu University of Traditional Chinese Medicine.

Chengdu University of Traditional Chinese Medicine.

出版信息

Medicine (Baltimore). 2020 Jan;99(3):e18848. doi: 10.1097/MD.0000000000018848.

Abstract

BACKGROUND

Endometrial thickness has been identified as a prognostic factor for pregnancy rate for patients with female infertility. Thin endometrium is defined as <7 mm on the day of ovulation, or on the day of human chorionic gonadotrophin (HCG) injection in fresh in vitro fertilization (IVF) cycles, or the day to start progesterone in frozen-thaw embryo transfer cycles, as stated in the guideline of thin endometrium from the Canadin Fertility and Andrology Society and Chinese expert consensus from the Society of Reproductive Medicine, Chinese Medical Association. Many medicines are used for improving the endometrial thickness and embryo implantation rate of the patients with thin endometirum, but thin endometrium remains a major troublesome clinical problem with limited efficacy.Platelet-rich plasma (PRP), as a growing and robust therapeutic option in musculoskeletal medicine, is a preparation of autologous plasma with a high concentration of platelets, and the therapeutic mechanism is based on the capacity to supply supra physiologic amounts of essential growth factors to provide a regenerative stimulus for promoting repair in tissues with low healing potential. Some randomized controlled trials have reported the application of PRP for patients with thin endometrium with satisfactory effect. However, there is no systematic review on efficacy and safety of PRP as a treatment of thin endometrium.

METHODS

The data and information will be retrieved from the databases of MEDLINE, Embase, Web of Science, Clinicaltrials.org., Cochrane Library, China Biology Medicine Database, Wan Fang Database, China National Knowledge Infrastructure Database, VIP Science Technology Periodical Database, and OpenGrey for gray literature. The randomized controlled clinical trials are going to be selected before December 20, 2019, in English or Chinese language, with the search terms including "thin endometrium,""platelet-rich plasma," "endometrial thickness," "hemorheology of endometrium," "pregnancy rate," and "adverse reactions." RevMan 5.3 will be used for systematic review and meta-analysis. This protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported with the PRISMA statement.

RESULTS AND CONCLUSION

The efficacy and safety of PRP for the treatment of thin endometrium will be evaluated, and the conclusion will be published to provide medical evidence for a better clinical decision of patients with thin endometirum.

摘要

背景

子宫内膜厚度已被确定为女性不孕症患者妊娠率的一个预后因素。根据加拿大生育与男科学会关于薄型子宫内膜的指南以及中华医学会生殖医学分会的中国专家共识,薄型子宫内膜定义为:在排卵日、新鲜体外受精(IVF)周期中注射人绒毛膜促性腺激素(HCG)之日,或冻融胚胎移植周期中开始使用孕酮之日,子宫内膜厚度<7mm。许多药物被用于改善薄型子宫内膜患者的子宫内膜厚度和胚胎着床率,但薄型子宫内膜仍然是一个主要的临床难题,疗效有限。富血小板血浆(PRP)作为肌肉骨骼医学中一种不断发展且有效的治疗选择,是一种含有高浓度血小板的自体血浆制剂,其治疗机制基于能够提供超生理量的必需生长因子,为愈合潜力低的组织提供再生刺激以促进修复。一些随机对照试验报道了PRP应用于薄型子宫内膜患者取得了满意的效果。然而,尚无关于PRP治疗薄型子宫内膜疗效和安全性的系统评价。

方法

数据和信息将从MEDLINE、Embase、Web of Science、Clinicaltrials.org.、Cochrane图书馆、中国生物医学数据库、万方数据库、中国知网数据库、维普科技期刊数据库以及OpenGrey灰色文献数据库中检索。将选取2019年12月20日前发表的、语言为英文或中文的随机对照临床试验,检索词包括“薄型子宫内膜”“富血小板血浆”“子宫内膜厚度”“子宫内膜血液流变学”“妊娠率”和“不良反应”。将使用RevMan 5.3进行系统评价和荟萃分析。本方案将根据系统评价和荟萃分析方案的首选报告项目(PRISMA-P)声明进行报告,系统评价将根据PRISMA声明进行报告。

结果与结论

将评估PRP治疗薄型子宫内膜的疗效和安全性,并发表结论,为薄型子宫内膜患者的更好临床决策提供医学依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/24c1/7220421/3cdfb1db80c0/medi-99-e18848-g002.jpg

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