Live Birth Rates in Poor Responders' Group after Previous Treatment with Autologous Platelet-Rich Plasma and Low Dose Ovarian Stimulation Compared with Poor Responders Used Only Low Dose Ovarian Stimulation Before in Vitro Fertilization.
Live Birth Rates in Poor Responders' Group after Previous Treatment with Autologous Platelet-Rich Plasma and Low Dose Ovarian Stimulation Compared with Poor Responders Used Only Low Dose Ovarian Stimulation Before in Vitro Fertilization.
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DOI：
10.3889/oamjms.2019.825
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发表时间：
2019-10-15
影响因子：
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通讯作者：
Petanovski, Zoran
中科院分区：
文献类型：
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作者：
Stojkovska, Snezhana;Dimitrov, Gligor;Petanovski, Zoran
背景技术背景：这项前瞻性初步研究确定了在体外受精（IVF）/卵胞浆内单精子注射（ICSI）联合低剂量卵巢刺激前，既往经阴道卵巢内注射自体富血小板血浆（PRP）对符合博洛尼亚标准的卵巢反应不良（POR）患者的疗效。目前对PORs有效治疗的认识是有限的，而且往往是相互矛盾的;此外，IVF的LBR仍然非常低。目的：我们评估了先前使用PRP进行卵巢治疗后PORs的活产率（LBR）。方法：总体而言，包括2017年6月至2018年12月期间接受IVF/ICSI的40例患者。对20例患者进行了经阴道卵巢内注射PRP。两个比较组的所有基本特征都是平衡的，并且进行了多变量分析以调整所有已知的混杂因素。结果：在两组之间，PRP组的临床妊娠率和活产率分别为33.33 ± 44.99和40.00 ± 50.71，PRP组的临床妊娠率和活产率分别为10.71 ± 28.95和14.29对照组回顾性分析为± 36.31。然而，在既往接受过PRP治疗的患者中，存在着床率和LBR更高的趋势。无论如何，本研究中使用的患者数量不足以得出具体的结论，需要未来更多的研究来完全证实这些结果。尽管POR应答者的治疗仍然是一个治疗挑战，在IVF实施前卵巢内注射自体PRP在POR中的使用为增加临床妊娠定义的IVF成功率带来了新的希望和LBR。
BACKGROUND: This prospective pilot study determined the efficacy of previous transvaginal intraovarian injection with autologous platelet-rich plasma (PRP) in poor ovarian responders (PORs) fulfilling the Bologna criteria before in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) with low dose ovarian stimulation. Current knowledge of efficient treatment for PORs is limited and often contradictory; also, LBRs of IVF remains disappointingly low.AIM: We assessed the live birth rates (LBRs) in PORs after previous ovarian treatment with PRP.METHODS: Overall, 40 patients undergoing IVF/ICSI between June 2017 ending December 2018 were included. A transvaginal intraovarian injection of PRP was performed on 20 patients. Both compered groups were balanced for all basic characteristics, and multivariate analysis was performed to adjust for all known confounders.RESULTS: Between the groups, a statistical significance in clinical pregnancies and LBR was not found. Clinical pregnancy and live birth rates were 33.33 ± 44.99 and 40.00 ± 50.71 in the PRP group and 10.71 ± 28.95 and 14.29 ± 36.31 in control group retrospectively. However, there is a trend towards higher implantation rates and LBRs in patients with previous treatment with PRP. Anyhow, the number of patients used in the research is insufficient to make a concrete conclusion, and more studies are needed in the future to confirm these results entirely.CONCLUSION: Even though the treatment of POR responders remains as a therapeutical challenge, the usage of intraovarian injection of autologous PRP in PORs before the IVF performance brings a glimpse of new hope in increasing the success of IVF defined by clinical pregnancy and LBRs.