scholarly journals Effectiveness of Intrauterine Infusion of Autologous Platelet-Rich Plasma in the Treatment of Thin Endometrium of Infertile Women

Author(s):  
Namrata Choudhary ◽  
Akash More ◽  
Roshankumar Jha ◽  
Ashish P. Anjankar

One of the key factors in implantation and pregnancy is endometrium. Sufficiently great percentage of in vitro fertilization failure is because of the endometrial receptivity therefore, high quality embryo and adequate receptive endometrial growth are important for successful implantation. Platelet rich plasma has beneficial effect in advancement of endometrial thickness for women with thin endometrial thickness. PRP can be used in various medical conditions including  patients with refractory endometrium as a complementary therapy to conventional  treatment. Aim: To determine the effectiveness of intrauterine infusion of autologous platelet-rich plasma in the treatment of thin endometrium of infertile women. Objectives: To identify infertile female patients with inadequate endometrial growth (less than 7 mm) in the past frozen embryo transfer (FET) cycles despite standard treatments. To observe intrauterine infusion of autologous platelet-rich plasma (PRP) in these infertile female patients with thin endometrium. To determine the effectiveness of intrauterine infusion of autologous PRP in the treatment of thin endometrium of infertile women during In vitro fertilization (IVF). Methods: It is a prospective observational study. Present study will be carried out with 30 patients. Women having inappropriate endometrial thickness of less than 7 mm, in past FET cycles will be included. Sonographic machine will be used; to measure endometrial thickness by  an expert Gynecologist, where thickest part of uterus will be measured in longitudinal  axis.  Expected Results: It is expected that intra uterine infusion of PRP will be effective in thickening of endometrial wall in patients with thin endometrium. Once the results are satisfactory it can be helpful for endometrial preparation in reproduction techniques. Conclusion: Present study is purposed to testify PRP as a novel method for advancement of reproductive medicine, it will be helpful to overcome with the issues such as inadequate thickness of endometrium, poor response to conventional therapy and increase clinical pregnancies and live births positively.

2018 ◽  
Vol 8 (1) ◽  
pp. 1 ◽  
Author(s):  
Konstantinos Sfakianoudis ◽  
Mara Simopoulou ◽  
Nikolaos Nitsos ◽  
Anna Rapani ◽  
Athanasios Pappas ◽  
...  

This report presents the case of a woman aged 40 who has experienced premature menopause from the age of 35. Having rejected oocyte donation, she opted for intraovarian injection of autologous platelet-rich plasma with the aim to rejuvenate the ovarian tissue and enable the employment of her own gametes through in-vitro fertilization. Six weeks following the autologous platelet-rich plasma treatment, a significant reduction in the patient’s follicle-stimulating hormone (FSH) levels were noted. A natural in-vitro fertilization cycle led to a biochemical pregnancy, resulting in a spontaneous abortion at the 5th week of pregnancy. This is the first report of a successful autologous platelet-rich plasma application leading to pregnancy in menopause. This report uniquely contributes to the medical knowledge and challenges current practice in the context of infertility. The efficiency and safety of this treatment with regard to the reproductive system merits further investigation.


Author(s):  
E. Scott Sills ◽  
E. Scott Sills ◽  
J. L. Petersen ◽  
N. S. Rickers ◽  
Samuel H. Wood ◽  
...  

This registered, prospective clinical trial assessed serum anti-Mullerian hormone (AMH) patterns after treatment with activated platelet rich plasma (PRP). Patients with low ovarian reserve and/or at least 1 prior failed in vitro fertilization (IVF) cycle (n=182) received PRP injected into ovarian tissue under ultrasound guidance. Pretreatment AMH, BMI and platelet (PLT) concentration were recorded and serum AMH, follicle stimulating hormone, and estradiol were then measured at 2-week intervals for up to three months. Mean±SD patient age was 45.4±6.1yrs. Improved serum AMH was observed in 51 patients (28%) with median increase of 167% [95%CI 91; 280] after treatment; mean interval to maximum AMH increase was 4 weeks (range 2-10 weeks). Improved post-treatment AMH was not limited to younger patients; when stratified by age (<42 vs. ≥42yrs), significant AMH improvements were seen in both groups after treatment (p=0.03 and 0.009, respectively). Among responders, mean basal PLT count was higher (274K) vs. non-responders (250K); p<0.001. This is the first clinical trial to describe an intraovarian PRP technique for low reserve and finds the treatment safe and associated with significant increases in serum AMH for some patients, usually within four weeks. The substantially different pre-treatment PLT concentrations measured across PRP response groups warrants further investigation. Additional research can characterize ovarian response better, optimize PRP protocols, and collect outcomes data from those who subsequently undergo IVF with autologous oocytes.


2019 ◽  
Vol 2 (2) ◽  
pp. 80-82
Author(s):  
Sara Mahmood ◽  
Salma Kafeel ◽  
Riffat Bibi ◽  
Naveed Iqbal

Inadequate endometrial proliferation is a known cause of implantation failure in assisted reproductive technology cycles. It is generally agreed that >9 mm endometrial thickness is associated with higher implantation. Several strategies have been explored to enhance endometrial proliferation. However, the results are either poor, inconsistent or subject to safety concerns. A 34-year old woman presented with unexplained thin endometrium in successive frozen embryo transfer (FET) cycles. Autologous platelet-rich plasma (PRP) was infused in the uterine cavity on day 10 of second FET cycle enhancing endometrial thickness, which post-PRP infusion measured 10.9 mm. Blastocyst-stage embryos were transferred resulting in a successful pregnancy. Autologous intrauterine infusion of PRP positively impacts endometrial proliferation and implantation which is safe, low resource and minimally invasive.


Author(s):  
E. Scott Sills ◽  
Natalie S. Rickers ◽  
Samuel H. Wood

Background: The use of autologous platelet-rich plasma as an ovarian treatment has not been standardized and remains controversial. Case Presentation: A 41½-year old woman with diminished ovarian reserve (serum anti- Müllerian hormone = 0.163 mg/mL) and a history of 10 unsuccessful in vitro fertilization cycles presented for reproductive endocrinology consult. She and her partner declined donor oocyte in vitro fertilization. They were both in good general health and laboratory tests were unremarkable, except for mild thrombocytosis (platelets = 386K; normal range 150-379K) discovered in the female. The patient underwent intraovarian injection of fresh platelet-derived growth factor concentrate administered as an enriched cell-free substrate. Serum anti- Müllerian hormone increased by 115% within 6 wks of treatment. Spontaneous ovulation occurred the month after injection and subsequently the serum human chorionic gonadotropin was noted at 804 mIU/mL. Following an uneventful obstetrical course, a male infant was delivered at term without complication. Conclusion: This is the first description of intraovarian injection of enriched platelet-derived growth factors followed by unassisted pregnancy and live birth. As a refinement of conventional ovarian platelet-rich plasma therapy, this procedure may be particularly valuable for refractory cases where prognosis for pregnancy appears especially bleak. A putative role for thrombocytosis is also viewed in parallel with mechanisms of action as advanced earlier. With continued experience in ovarian application of autologous platelet growth factors, additional research will evaluate laboratory protocol/sample preparation, injection technique, and patient selection. Key words: Ovarian rejuvenation, Platelet-rich plasma, Cytokines, Infertility, IVF.


2019 ◽  
Vol 28 (9-10) ◽  
pp. 1333-1340 ◽  
Author(s):  
Konstantinos Pantos ◽  
Mara Simopoulou ◽  
Agni Pantou ◽  
Anna Rapani ◽  
Petroula Tsioulou ◽  
...  

Since the introduction of autologous platelet-rich plasma (PRP) in medical practice, various studies have documented that implementing PRP can enhance healing and the anti-aging process, employing angiogenesis regeneration due to the multiple growth factors and cytokines involved. Numerous reports have shown promising results with the use of PRP in ovarian treatment, regarding ovarian regeneration and reactivation of folliculogenesis. This case series reports on two women with premature ovarian failure (POF) aged 40 and 27 years, respectively, and one menopausal woman aged 46 years. All patients presented with lack of menstrual cycle for over a year. The women reported previous failed in vitro fertilization (IVF) attempts, and, after rejecting the option of oocyte donation, they opted for the approach of autologous ovarian PRP treatment. Following PRP treatment, the three patients were invited to conceive naturally. The primary outcome was the restoration of menstruation following autologous ovarian PRP treatment, as well as an improvement in hormonal profile, a decrease in follicle-stimulating hormone (FSH) levels, and a concurrent increase in anti-Müllerian hormone (AMH) levels. Further to that, our patients achieved pregnancy through natural conception within 2–6 months following PRP treatment, resulting in currently ongoing complication-free clinical pregnancies – a first report in the literature for menopausal and POF patients. Implementation of PRP should be further investigated through randomized controlled trials (RCTs), as it may hold the key to successful treatment for a certain cohort of patients exploring reproductive treatment options following menopause.


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