Efficacy and safety of autologous platelet‐rich fibrin for the treatment of infertility with intrauterine adhesions

Abstract

Aim To evaluate the efficacy and safety of autologous platelet‐rich fibrin (PRF) for the treatment of infertility with intrauterine adhesions. Methods Forty patients who suffered from infertility with intrauterine adhesions (IUAs) were enrolled in this prospective trial from October 2018 to December 2019. They were randomly divided into a PRF group and a control group. Both groups underwent transcervical resection of adhesions (TCRA) during the follicular phase. PRF group: PRF prepared from autologous venous blood was placed in the uterine cavity after TCRA and after the first menstrual re‐fluid; control group: no PRF insertion. After the second menstrual re‐fluid, both groups underwent hysteroscopy to reevaluate adhesion severity. Pregnancy rate, intrauterine adhesion score, menstrual volume and duration, and endometrial thickness were assessed and adverse events were recorded. Results (1) PRF group pregnancy rate was significantly higher than the control group (55.0% vs. 20.0%). Mean follow‐up time was (17.63 ± 2.33) months. All patients fell pregnant naturally. Four (PRF) and one (control) patients delivered live births without placental complications. (2) Intrauterine adhesion scores decreased compared with treatment‐before. (3) In the pictorial blood loss assessment chart, score and menstrual duration during the 3rd menstrual cycle showed significant improvements for both groups. (4) Endometrial thickness also showed an increasing trend, and subendometrial bloodflow improved. (5) No treatment‐related serious adverse events were noted. Conclusion Placing PRF into the uterine cavity of infertility patients with IUAs following TCRA is a safe and effective therapeutic method.

Applications of Hydrogels in Premature Ovarian Failure and Intrauterine Adhesion

“…Traditional 2D culture achieve the survival of follicles in vitro, but cannot maintain the normal morphology of follicles (Desai et al, 2012;Choi et al, 2013), the 3D structure of the swollen hydrogels maintains the normal morphology of the follicles in vitro. Hydrogels are promisingly applied to treat IUA, because hydrogels are not easily expelled due to the strong adhesion to uterine walls Yang et al, 2020), and the stable 3D structure due to swelling prevents adjacent uterine walls from directly contacting (Mettler et al, 2008;Wang, Z. et al, 2021).…”

Оптимизация Лечения Маточного Бесплодия На Основе Использования Богатого Тромбоцитами Фибрина (I-Prf)

“…PRF (platelet rich fibrin) имеет множество преимуществ, включая более короткий послеоперационный период, уменьшение боли, послеоперационных отеков и гематом, улучшение заживления ран [13]. Имеются лишь единичные работы по применению i-PRF для лечения бесплодия с внутриматочными спайками [39][40][41].…”