META-ANALYSIS OF THE EFFICACY OF INTRAUTERINE INFUSION OF PLATELET-RICH PLASMA FOR THIN ENDOMETRIAL LINING

Feifei Gan¹, Min Du², Minqi Zhang^{1, *}

¹Department of Reproductive Medicine, Shenzhen Luohu People’s Hospital, Shenzhen, Guangdong 518000, China - ²Department of Gynaecology, Shenzhen Luohu People’s Hospital, Shenzhen, Guangdong 518000, China

Introduction: Endometrial thickness (EMT) is the key to affect the success of embryo transfer and the normal conception. This research aimed to determine the effect of intrauterine infusion of platelet-rich plasma (PRP) for patients with thin endometrial lining. 

Materials and methods: Articles from January 2015 to June 2022 were retrieved from the Cochrane Library, PubMed, MEDLINE, web of science, Chinese Biomedical Literature Database, Wanfang database and EMBASE. All randomized controlled studies on intrauterine infusion of PRP for patients with thin endometrial lining were selected, screened, extracted for data and assessed for quality using Newcastle-Ottawa Scale (NOS) by 2 evaluators independently. RevMan 5.3 software was taken for meta-analysis. 

Results: A total of 9 articles were selected, with 839 patients in total (430 patients in the observation group, 409 patients in the control group). The observation group showed thicker endometrial lining on the day of progesterone administration (MD=1.01, 95% CI: 0.69, 1.34; P<0.00001), higher implantation rate (OR=3.65, 95% CI: 1.88, 7.08; P=0.0001), biochemical pregnancy rate (OR=3.30, 95% CI: 2.27, 4.82; P<0.00001), clinical pregnancy rate (OR=3.88, 95% CI: 2.78, 5.41; P<0.00001) and cycle cancelation rate (OR=0.20, 95% CI: 0.09,0.45; P<0.0001) than the control group, with significant differences. No significant difference was observed in the abortion rates in the early stage between the 2 groups (OR=1.12, 95% CI: 0.31, 3.99; P=0.87). 

Conclusion: Intrauterine perfusion of PRP could optimize the pregnancy outcome of patients with thin endometrial lining and is a safe and efficacious treatment for infertile patients with thin endometrial lining.