RÉSUMÉ
Objective:To analyze the impact of intrauterine infusion of autologous peripheral blood mononuclear cells (PBMCs) and enriched platelet plasma (PRP) on pregnancy outcomes in patients with recurrent implantation failure (RIF).Methods:A total of 96 patients with repeated implantation failures who underwent frozen embryo cycles at Hunan Provincial Maternal and Child Health Care Hospital from March 2021 to June 2023 were selected and randomly divided into a control group (19 cases), PBMCs group (31 cases), and PRP group (46 cases). The control group did not receive uterine cavity infusion treatment; Intrauterine perfusion of PBMCs in the PBMCs group; The uterine cavity of the PRP group was infused with PRP. We compared the general situation, endometrial thickness on the day of conversion, endometrial thickness on the day of transplantation, embryo implantation rate, and clinical pregnancy rate among three groups.Results:There was no statistically significant difference in age, body mass index (BMI), years of infertility, menstrual cycle, serum basal follicle stimulating hormone (FSH), basal estradiol (E 2), number of transfer cycles, number of transferred embryos, and number of high-quality embryos among the three groups (all P>0.05). There was no statistically significant difference in endometrial thickness on the conversion day among the control group, PRP group, and PBMCs group (all P>0.05). The endometrial thickness on the day of transplantation in the PRP group was greater than that in the control group and PBMCs group (all P<0.05), and there was no statistically significant difference in endometrial thickness on the day of transplantation between the control group and PBMCs group (all P>0.05). The embryo implantation rate and clinical pregnancy rate of the PRP group and PBMCs group were higher than those of the control group, and the difference was statistically significant (all P<0.05). There was no statistically significant difference in embryo implantation rate and clinical pregnancy rate between the PRP group and the PBMCs group (all P>0.05). The patients did not experience any adverse reactions such as infection, abdominal pain, or vaginal bleeding during intrauterine infusion therapy. Conclusions:Infusing autologous PBMCs or PRP into the uterine cavity before re embryo transfer in RIF patients can significantly improve embryo implantation rate and clinical pregnancy rate, and can improve assisted pregnancy outcomes; Intrauterine infusion of autologous PRP has no significant advantage over PBMCs in improving clinical pregnancy outcomes in patients with RIF; But it is more beneficial for improving the thickness of the endometrium.
RÉSUMÉ
Objective:To investigate the assisted pregnancy clinical effect of autologous peripheral blood mononuclear cells (PBMCs) combined with low molecular weight heparin (LMWH) on patients with intrauterine adhesion separation.Methods:Nine patients with intrauterine adhesion separation were treated with intrauterine perfusion of PBMCs 48 hours before transplantation. The low molecular weight heparin 3 200 IU injected daily subcutaneously were carried out on the day of transplantation. Measurement of endometrial thickness and observation of pregnant outcome were perfomed.Results:After 9 patients were injected into the uterine cavity with autologous PBMCs. It was found that, compared to the previous, the thickness of the endometrium was increased, and the morphology of the endometrium was improved in 6 cases. After transplantation, 7 cases of the patients were clinically pregnant, 1 of the patients was biochemically pregnant, and 1 of the patients was not pregnant; among the 7 clinical pregnancy cases, 1 case was intrauterine compound pregnancy (operation on the affected side of fallopian tube pregnancy had been performed), another 2 cases had embryo termination at the 7-8th week of gestation by B-scan ultrasonography analysis. However, 3 cases of clinical pregnancy in 4 patients with repeated implantation failure. At present, 2 cases were in live labor, and the other three cases were in normal continuous pregnancy.Conclusions:Intrauterine perfusion of human PBMCs combined with low molecular weight heparin is beneficial to the improvement of endometrial receptivity and the pregnancy outcome of some patients after the separation of intrauterine adhesions.