Management of a Thin Endometrium by Hysteroscopic Instillation of Platelet-Rich Plasma Into The Endomyometrial Junction: A Pilot Study

被引:39
作者
Agarwal, Meenu [1 ]
Mettler, Liselotte [2 ]
Jain, Smita [1 ]
Meshram, Sandhya [1 ]
Gunther, Veronika [2 ]
Alkatout, Ibrahim [2 ]
机构
[1] Morpheus Bliss Fertil Ctr, Pune 411001, Maharashtra, India
[2] Univ Hosp Schleswig Holstein, Dept Obstet & Gynecol, Arnold Heller Str 3,House C, D-24105 Kiel, Germany
关键词
platelet-rich plasma (PRP); thin endometrium; hysteroscopy; STEM-CELLS; STEM/PROGENITOR CELLS; ANGIOGENESIS; IMPLANTATION; THICKNESS; GROWTH; PATHOGENESIS; INFERTILITY; PREDICTOR; ZONE;
D O I
10.3390/jcm9092795
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In patients whose embryo transfer has been previously canceled due to a thin endometrium, the injection of platelet-rich plasma (PRP) guided by hysteroscopy into the endomyometrial junction improves endometrial thickness and vascularity. This may well serve as a novel approach for the management of these patients. In this study, 32 patients aged between 27 and 39 years, suffering from primary or secondary infertility, were selected for hysteroscopic instillation of PRP. This cross-sectional study included a retrospective assessment of the improvement of endometrial thickness (>7 mm) on the commencement of progesterone treatment in 24 of 32 patients (75%) after hysteroscopy-guided injections of PRP into the subendometrial zone. After PRP instillation, the endometrium was 7 mm or thicker in 24 of 32 patients, and all 24 patients underwent frozen embryo transfer. Moreover, 12 of 24 patients who underwent embryo transfer conceived, whereas 10 had a clinical pregnancy with visualization of cardiac activity at 6 weeks and two had a biochemical pregnancy. Our approach of PRP injection into the subendometrial region is consistent with the histologically proven regeneration of the endometrium from the endomyometrial junction. We observed an improvement of endometrial thickness and higher pregnancy rates in cases of previously canceled embryo transfer due to a thin endometrium.
引用
收藏
页码:1 / 12
页数:12
相关论文
共 42 条
[1]   ENDOMETRIAL THICKNESS - A PREDICTOR OF IMPLANTATION IN OVUM RECIPIENTS [J].
ABDALLA, HI ;
BROOKS, AA ;
JOHNSON, MR ;
KIRKLAND, A ;
THOMAS, A ;
STUDD, JWW .
HUMAN REPRODUCTION, 1994, 9 (02) :363-365
[2]   A PROSPECTIVE-STUDY OF ECHOGRAPHIC ENDOMETRIAL CHARACTERISTICS AND PREGNANCY RATES DURING HORMONAL REPLACEMENT CYCLES [J].
ALAM, V ;
BERNARDINI, L ;
GONZALES, J ;
ASCH, RH ;
BALMACEDA, JP .
JOURNAL OF ASSISTED REPRODUCTION AND GENETICS, 1993, 10 (03) :215-219
[3]   Insufficient Angiogenesis: Cause of Abnormally Thin Endometrium in Subfertile Patients? [J].
Alfer, Joachim ;
Happel, Lars ;
Dittrich, Ralf ;
Beckmann, Matthias W. ;
Hartmann, Arndt ;
Gaumann, Andreas ;
Buck, Volker U. ;
Classen-Linke, Irmgard .
GEBURTSHILFE UND FRAUENHEILKUNDE, 2017, 77 (07) :756-764
[4]  
Chang YJ, 2015, INT J CLIN EXP MED, V8, P1286
[5]   Extended estrogen administration for women with thin endometrium in frozen-thawed in-vitro fertilization programs [J].
Chen, Mei-Jou ;
Yang, Jehn-Hsiahn ;
Peng, Fu-Hsiang ;
Chen, Shee-Uan ;
Ho, Hong-Nerng ;
Yang, Yu-Shih .
JOURNAL OF ASSISTED REPRODUCTION AND GENETICS, 2006, 23 (7-8) :337-342
[6]   Endometrial stem/progenitor cells and their role in the pathogenesis of endometriosis [J].
Cousins, Fiona L. ;
Dorien, F. O. ;
Gargett, Caroline E. .
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY, 2018, 50 :27-38
[7]   Asherman's syndrome: current perspectives on diagnosis and management [J].
Dreisler, Eva ;
Kjer, Jens Joergen .
INTERNATIONAL JOURNAL OF WOMENS HEALTH, 2019, 11 :191-198
[8]   The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles [J].
El-Toukhy, Tarek ;
Coomarasamy, Arri ;
Khairy, Mohammed ;
Sunkara, Kamal ;
Seed, Paul ;
Khalaf, Yacoub ;
Braude, Peter .
FERTILITY AND STERILITY, 2008, 89 (04) :832-839
[9]   Uterine stem cells: What is the evidence? [J].
Gargett, C. E. .
HUMAN REPRODUCTION UPDATE, 2007, 13 (01) :87-101
[10]   Potential role of endometrial stem/progenitor cells in the pathogenesis of early-onset endometriosis [J].
Gargett, C. E. ;
Schwab, K. E. ;
Brosens, J. J. ;
Puttemans, P. ;
Benagiano, G. ;
Brosens, I. .
MOLECULAR HUMAN REPRODUCTION, 2014, 20 (07) :591-598