自体血小板富集血浆联合粒细胞集落刺激因子宫腔灌注对反复着床失败患者子宫内膜容受性 及临床结局的影响.

OBJECTIVE: To probe into the effects of autologous platelet-rich plasma (PRP) combined with granulocyte colony-stimulating factor (G-CSF) for intrauterine perfusion on endometrial receptivity (ER) and clinical outcome in patients with repeated implantation failure (RIF). METHODS: Totally 76 patients with RIF admitted into this hospital from Jan. 2020 to Jul. 2022 were selected and divided into PRP+G-CSF perfusion group (38 cases) and control group (no perfusion, 38 cases) according to whether or not intrauterine perfusion was performed before frozenthawed embryo transfer. The embryo implantation rates, chemical pregnancy rates, clinical pregnancy rates, early miscarriage rates and ectopic pregnancy rates of both groups were recorded, the thickness, morphology, blood flow type and hemodynamic indexes [uterine artery pulsatility index (PI), resistance index (RI)] of endometrium were compared between two groups on the day of embryo transfer, and the incidence of adverse events of uterine perfusion in the PRP+G-CSF group was recorded. RESULTS: After treatment, the embryo implantation rate, chemical pregnancy rate and clinical pregnancy rate of the PRP+G-CSF group were respectively 46. 88% (30/38), 60. 53% (23/38) and 60. 53% (23/38), which were higher than those of the control group [26. 56%(17/38), 31. 58%(12/38) and 31. 58%(12/38)], with statistically significant differences (P<0. 05). The early abortion rates were 4. 35% (1/23) and 16. 67% (2/12) in the two groups, with no statistically significant difference (P>0. 05). No ectopic pregnancy occurred in both groups, and there were no adverse events of intrauterine perfusion in the PRP+G-CSF group. On the day of embryo transfer, the endometrial thickness of patients in the PRP +G-CSF group was (10. 20±2. 02) mm, which was thicker than that of the control group [(9. 15±1. 51) mm], with statistically significant difference (P < 0. 05); the percentage of endometrial blood flow type GⅡ or above and the percentage of C-type endometrium were respectively 86. 84% (33/38) and 89. 47% (34/38), which were higher than those in the control group [65. 79% (25/38) and 71. 05%(27/38)], with statistically significant differences (P<0. 05). On the day of embryo transfer, the uterine artery PI and RI levels of patients in the PRP+G-CSF group were 2. 35±0. 53 and 0. 83±0. 08, which were lower than those of the control group (2. 69±0. 49 and 0. 87±0. 09), with statistically significant differences (P < 0. 05). CONCLUSIONS: PRP combined with G-CSF intrauterine perfusion can improve endometrial thickness and blood perfusion in patients with RIF, thus improve their ER and pregnancy outcomes. [ABSTRACT FROM AUTHOR]