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宫腔内输注和宫腔镜下注射自体富血小板血浆治疗持续性薄子宫内膜患者:一项前瞻性病例对照研究

Intrauterine Infusion and Hysteroscopic Injection of Autologous Platelet-Rich Plasma for Patients with a Persistent Thin Endometrium: A Prospective Case-Control Study.

作者信息

Yu Tzu-Ning, Lee Tsung-Hsien, Lee Maw-Sheng, Chen Yi-Chun, Chen Chung-I, Cheng En-Hui, Lin Pin-Yao, Huang Chun-Chia, Lee Chun-I

机构信息

Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan.

Division of Infertility, Lee Women's Hospital, Taichung 406, Taiwan.

出版信息

J Clin Med. 2024 May 11;13(10):2838. doi: 10.3390/jcm13102838.

Abstract

: To evaluate the effect of intrauterine infusion and hysteroscopic injection of autologous platelet-rich plasma (PRP) in patients with a persistent thin endometrium (EM) undergoing euploid frozen embryo transfer (EFET) cycles. : This prospective case-control study enrolled 116 infertile women with thin EM (<7 mm) who underwent hormone replacement therapy (HRT) for EFET. These women had experienced at least one previous unsuccessful EFET cycle, which either resulted in the cancellation of the cycle or failure of pregnancy. A total of 55 women received an intrauterine infusion of PRP before FET, 38 received a hysteroscopic injection of PRP, and 23 received standard HRT treatment without PRP (control group). Only euploid embryos were transferred in these cycles. The primary outcomes were the implantation rate (IR) and clinical pregnancy rate (CPR) after EFET. : After receiving intrauterine infusion and hysteroscopic injection of PRP, 78.2% and 55.3% of patients, respectively, showed an EM thickness exceeding 7 mm, followed by embryo transfer. The hysteroscopic injection group demonstrated significantly higher IR (52%), a higher trend of CPR (52%), and a higher live birth rate (38%) than the control group (18%, 22%, and 4%). : Intrauterine infusion and hysteroscopic injection of autologous PRP may be effective methods to increase EM thickness in HRT cycles. According to our results, both methods could increase EM thickness, while hysteroscopic injection appeared to provide more significant assistance in increasing IR, CPR, and live birth rate after EFET in patients with persistent thin EM.

摘要

评估宫腔内输注和宫腔镜注射自体富血小板血浆(PRP)对接受整倍体冷冻胚胎移植(EFET)周期的持续性薄子宫内膜(EM)患者的影响。

本前瞻性病例对照研究纳入了116例EM薄(<7mm)的不孕妇女,她们接受激素替代疗法(HRT)进行EFET。这些妇女此前至少经历过一次EFET周期未成功,导致周期取消或妊娠失败。共有55例妇女在FET前接受宫腔内PRP输注,38例接受宫腔镜下PRP注射,23例接受无PRP的标准HRT治疗(对照组)。这些周期仅移植整倍体胚胎。主要结局是EFET后的着床率(IR)和临床妊娠率(CPR)。

接受宫腔内输注和宫腔镜注射PRP后,分别有78.2%和55.3%的患者EM厚度超过7mm,随后进行胚胎移植。宫腔镜注射组的IR(52%)显著高于对照组,CPR(52%)有更高的趋势,活产率(38%)也高于对照组(18%、22%和4%)。

宫腔内输注和宫腔镜注射自体PRP可能是增加HRT周期中EM厚度的有效方法。根据我们的结果,两种方法都能增加EM厚度,而宫腔镜注射在增加持续性薄EM患者EFET后的IR、CPR和活产率方面似乎提供了更显著的帮助。

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