In a nutshell
This study compared the effectiveness of different intrauterine interventions for women with two or more implantation failures. The data showed that platelet-rich plasma (PRP) was the most effective intrauterine intervention in improving pregnancy outcomes in these women.
In vitro fertilization (IVF) is a widely used infertility technique. It involves collecting eggs and transferring the fertilized embryo(s) to the uterus. Implantation occurs when the embryo attaches to the lining of the uterus. It is common for not all embryos to implant. However, some women experience repeated lack of implantation following multiple IVF embryo transfers.
An embryo has foreign cells with different genetic material from the woman. It is the immune system’s job to determine whether foreign cells are from an embryo, from friendly bacteria which normally live in the uterus, or from harmful pathogens. Peripheral blood mononuclear cells (PBMCs) include several types of white blood cells of the immune system and can be collected during a blood donation. These PBMCs are involved in how receptive the uterine lining is. PBMCs behave differently when there are pregnancy hormones such as human chorionic gonadotropin (hCG).
There are a variety of potential treatments for repeated lack of implantation. Platelets are parts of the blood responsible for clotting. Platelet-rich plasma (PRP) may promote the lining of the uterus. Granulocyte colony-stimulating factor (G-CSF) is a hormone which encourages certain tissues to grow. G-CSF is involved in the growth of the lining of the uterus. It is important to compare the effectiveness of different intrauterine interventions like- PRP, PBMC, hCG, and G-CSF for women with two or more implantation failures.
Methods & findings
This study analyzed 21 other studies and involved a total of 3079 women. All these women had two or more implantation failures and were undergoing fresh or frozen embryo transfer. Patients received one of 6 treatments- PRP, PBMC, G-CSF, hCG, endometrial scratch (ES), and control treatment.
Compared with the control treatment, PRP significantly increased the clinical pregnancy rate by 3.78 times, PBMC by 2.79 times, G-CSF by 1.93 times, hCG by 1.8 times, and ES by 1.75 times. PRP was the best regimen in terms of increasing the clinical pregnancy rate followed by PBMC, G-CSF, hCG, and ES.
Compared with the control treatment, PRP significantly increased the live birth rate by 5.96 times, PBMC by 2.55 times, and ES by 1.70 times. PRP was the best regimen in terms of increasing the live birth rate followed by PBMC and ES.
The bottom line
This study concluded that PRP was the most effective intrauterine intervention in improving pregnancy outcomes in women with two or more implantation failures.
The fine print
Most studies analyzed had a small sample size and included patients treated at a single medical institution. The studies analyzed had different treatment protocols like ovarian stimulation, fresh versus frozen embryo transfer, and intrauterine interventions.
Published By :
Frontiers in Endocrinology
Sep 16, 2022