Dr Pankhuri shakya
., IndiaPresentation Title:
Retrospective observational study to evaluate the role of PRP in cases of unexplained implantation failure
Abstract
What is currently about the subject - Platelet-rich plasma (PRP) is gaining popularity as a method for treating the endometrium in the context of assisted reproduction. We investigated the use of endometrial injection of PRP for improving receptivity in the context of otherwise unexplained recurrent implantation failure. Hysteroscopic instillation of PRP in the sub endometrial region is a novel approach for the management of a refractory endometrium . PRP is autologous plasma derived from fresh whole blood enriched with platelets . It is prepared by collecting blood from peripheral veins and contains several growth factors such as VEGF , epidermal growth factor (EGF), platelet derived growth factor (PDGF) , transforming growth factor (TGF) , and other cytokines that stimulate proliferation and growth. Platelet also activate peripheral blood mononuclear cell (PBMC), which release IL-10, IL-10 is a cytokine involved in tissue regeneration.
STUDY DESIGN,SIZE,DURATION,MATERIAL AND METHOD- We retrospectively analyzed the data collected for all consecutive women who underwent treatment with PRP with history of one previous unexplained implantation failure in our service over the period 1/1/2021–31/10/2023. We examined demographic data (age, BMI, years in marital status), hormone levels (LH, FSH, AMH), endometrial thickness , and successful implantation/full-term pregnancy. Categorical data are presented as frequencies (%) and continuous as means±SD (range). The groups were compared with Fisher’s exact test (categorical) and t-test(continuous).
RESULT-The cohort comprised 41 women with unexplained previous one implantation failure , with a mean age of 33.5 ±5.69 years (23-46), a mean BMI of 26.9±3.94 kg/m2 (20-32), and a mean duration of marital status of 11.8 ±6.11 years (3-23). LH was normal in 38 women (92.7%) and FSH in 37 (90.2%), while the mean value of AMH was 3.2 ±2.28 IU/L (0.2-12.6). The mean endometrial thickness was 0.8 ±0.27 cm, translating into a difference of 0.2 ±0.29 (95% CI (-0.31)–(-0.08)]. Treatment with PRP led to successful implantation/full-term pregnancy in 28/41 cases (68.3%). Upon simple linear regression, the r value was 0.13, P value of < 0.0001 showing a positive correlation between the use of PRP and successful pregnancy outcomes.
Conclusion- In our cohort of 41 women with otherwise unexplained previous one implantation failure , endometrial injection of PRP led to a successful pregnancy rate of 68.3%. Larger-scale studies with randomized designs are needed to prove the validity of our findings.
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