Platelet-rich plasma or blood-derived products to improve endometrial receptivity?

Abstract

The use of platelet-rich plasma (PRP) to improve endometrial receptivity is gaining increasing attention in assisted reproduction technologies. The authors report that autologous PRP intrauterine administration improves pregnancy and birth rates, particularly in cases of patients presenting poor endometrial growth. Different groups of scientists proposed a similar approach years ago using whole blood-derived products also to improve endometrial receptivity. The important role played by cytokines and growth factors during embryo implantation has been well-known for a long time. These signaling molecules are present and released by blood cells during physiological, normal endometrial growth and implantation. Similar blood mediators are released from platelet granules upon a blood vessel injury. Methods described for PRP preparation for intrauterine administration are not precise, and they seem to be similar to those used to prepare peripheral blood-derived products. Thus, it is possible that when preparing PRP from whole blood, the final plasma product used as BPRP^contains platelets in addition to the important cytokines and growth factors released by the peripheral blood mononuclear cells present in the whole blood. Precise knowledge of the identity, concentration, and effects of the individual blood factors, their origin, whether platelets or blood mononuclear cells, will greatly contribute to improve and to make results obtained in fertility treatments more repeatable.

Implantation and the Fetal Health

“…Platelets contain a significant amount of growth factors that have positive effects on local tissue repair and endometrial receptivity. Several authors have reported autologous PRP intrauterine injection improves pregnancy and birth rates, especially in patients presenting poor endometrial growth [46].…”

The role of pregravid preparation in increased efficacy of IVF

“…По современным представлениям, для функционально здорового эндометрия, способного обеспечить физио-логическое течение всех этапов имплантации, характерны определенные признаки: соответствующие толщина и структура, особенности перфузии, наличие иммунокомпетентных клеток, определенных параметров метаболизма и эндометриального гомеостаза [4,10].…”

“…тельно, до настоящего времени не описаны четкие диагностические критерии целевой толщины эндометрия для подготовки к ЭКО, а также не определены методы ПП, поддерживающие толщину эндометрия, необходимую для имплантации. Доказано, что РЭ может быть нарушена при наличии ряда заболеваний, достаточно распространенных среди пациенток с бесплодием, в первую очередь хронического эндометрита (ХЭ) [4,16,30,31]. Известно, что диагноз ХЭ устанавливается у 30,3% пациенток с неэффективностью ЭКО, так как воспалительный процесс в эндометрии снижает показатели имплантации на 11,5% [4].…”

“…A. Bos-Mikich и соавт. [4] сообщили, что у больных с ХЭ лечение антибиотиками значительно улучшило репродуктивный результат в последующих циклах ЭКО.…”

Platelet-Rich plasma as an effective alternative approach for improving endometrial receptivity - a clinical retrospective study

“…Evidence shows that endometrial epithelium, decidualized stromal cells, and immune cells produce and secrete paracrine signaling molecules known as growth factors and cytokines involved in decidualization, blastocyst attachment, and invasion (Duc-Goiran et al, 1999;Dey et al, 2004). White blood cells and platelets produce and secrete cytokines and growth factors, some of which known for their associations with embryo implantation in humans (Bos-Mikich et al, 2019).…”