Therapeutic Effect Of Intrauterine Infusion Of Platelet-rich Plasma In Patients With Thin Endometrium

Objective:Platelet-rich plasma(PRP)intrauterine perfusion was performed on patients with thin endometrium who had failed embryo transplantation in the past,and endometrium receptivity and pregnancy outcomes before and after intrauterine perfusion were compared between PRP group and blank control group as well as PRP group,and the effectiveness and mechanism of PRP intrauterine perfusion were analyzed and related discussion was conducted.Methods:A total of 100 patients with thin endometrium who failed to receive FET in Assisted Reproduction Center of Sichuan Provincial People’s Hospital from June 2021 to October 2022 were included and randomly divided into PRP perfusion group and blank control group.PRP group received intrauterine perfusion on the 9th,11th and 13th day of menstruation,respectively,and retained intrauterine lavage solution 1 day before embryo transfer.In the blank control group,only one day before embryo transfer was left for uterine lavage.The levels of cytokines such as TGF-β 1,IL-17,IL-4 and TNF-α were detected.All subjects underwent three-dimensional energy intrauterine flow detection on the endometrial transformation day.Finally,the differences of endometrial three-dimensional blood flow detection,cytokine content and pregnancy outcome between PRP group and blank group were compared.At the same time,three-dimensional energy endometrial blood flow detection value and pregnancy outcome were observed through self-controlled study of pre-perfusion and post-perfusion cycles in PRP group.To investigate the effect and mechanism of intrauterine infusion of platelet-rich plasma in patients with thin endometrium.Results:1.Through comparative analysis between PRP group and blank control group,clinical pregnancy rate(43.48%vs 20.93%,P=0.028)was significantly increased in PRP group,but there were no significant differences in embryo implantation rate,HCG positive rate and early abortion rate(P>0.05).2.Compared with the blank control group,the intrauterine membrane thickness(0.69±0.013cm vs 0.61 ±0.01 lcm,P=0.008)and blood flow index FI(27.07±0.59 vs 23.62±0.40,P=0.023)were significantly increased in the PRP intrauterine perfusion group.There were no significant differences in endometrial volume,morphology,mean uterine spiral artery beating index PI,resistance index RI,vascular index VI and vascular blood flow index VFI(P>0.05).3.The contents of cytokines such as TGF-β 1,IL-17,IL-4 and TNF-α and the ratio of TNF-α/IL-4 in the intrauterine perfusion fluid of PRP group were not significantly different from those of the blank control group.IL-17/TGF-β1 ratio decreased significantly(19.35± 1.62 vs 24.56±2.04,P=0.034).4.A comparative analysis of patients with thin endometrium after PRP treatment also found that endometrium thickness(0.68±0.013cm vs 0.64±0.080cm,P=0.013),FI(27.07±0.59 vs 25.02±0.60,P=0.011)and vascular blood flow index(VFI)(1.03±0.09 vs 0.72±0.07,P=0.022)were significantly increased,but there were no significant differences in intima volume,PI,RI and VI(P>0.05).5.In terms of pregnancy outcome,compared with the control group,the clinical pregnancy rate(43.48%vs 12.50,P=0.005)and embryo implantation rate(36.84%vs 14.75,P=0.004)were significantly increased in PRP group,and the HCG positive rate and early abortion rate were not significantly different(P>0.05).Conclusion:Uterine perfusion of PRP can improve pregnancy outcome and clinical pregnancy rate and embryo implantation rate by improving uterine thickness and endometrial blood flow richness such as FI and VFI in patients with thin endometrial.