Platelets Rich Plasma and Infertility Treatment (PRP)

Platelets Rich Plasma – Introduction

Platelets rich plasma: Effective embryo implantation requires a proper embryonic development coincident with a receptive endometrium. In clinical practice, satisfactory endometrial growth is needed for successful implantation. The required minimum endometrial thickness for embryo transfer is seven millimeters after the follicular phase. Thin endometrium non-responsive to standard treatments is still a challenge in assisted reproductive technique, which usually results in cycle cancellation and unexpected embryo cryopreservation. Hence various strategies have been developed for treating thin endometrium, including extended use of exogenous estrogen, use of low-dose aspirin, vitamin E and vaginal sildenafil citrate, electroacupuncture and application of granulocyte colony stimulation factor (G-CSF). However, several women with thin endometrium remain non-responsive even after these remedies are used. Therefore those patients suffering from weak endometrial growth often ask whether the use of Platelets rich plasma, PRP in IVF can lead to a successful pregnancy. Also can treatment by platelet-rich plasma for endometrial lining will improve it. Alternatively, what is platelet-rich plasma therapy in IVF? Can platelet-rich plasma in repeated IVF failure work effectively? Can you explain PRP fertility treatment? What is PRP therapy in the uterus? Can you explain the use of PRP in IVF? How can PRP lead to IVF success? What is PRP procedure in IVF? Does PRP improve egg quality? Does PRP work in recurrent implantation failure? What is the best PRP treatment for male infertility? Can you explain PRP treatment in IVF in Hindi? Is IVF treatment after PRP possible? Are there any PRP fertility success stories you can share? Are there any infertility clinical trials with PRP carried out? These types of questions are being explained by the best IVF specialist in Pune Dr. Amol Lunkad providing his expert services at the Indira IVF clinic in Pune.

Platelet-rich plasma (PRP) is well prepared from fresh whole blood which is collected through a peripheral vein, kept in acid citrate dextrose solution A (ACD-A) anticoagulant and processed to enhance platelets by separating different parts of blood. Through activating platelets in PRP, cytokines in addition to growth factors (GFs) turn out to be bioactive and are released within 10 min right after clotting. These factors consist of vascular endothelial growth factor (VEGF), transforming growth factor, platelet-derived growth aspect, and epidermal growth factor. They can regulate cellular migration, attachment, proliferation plus differentiation, and promote extracellular matrix accumulation. Nowadays, PRP continues to be widely applied in several clinical scenarios, like orthopedics, ophthalmology, and injury healing to enhance tissue reconstruction. However, little is recognized about the application of PRP in the treatment of thin endometrium. This research was to find out the performance of PRP in the treatment of infertile women with a thin endometrium (≤ 7 mm) stated Dr. Amol Lunkad at the Indira IVF center in Pune.

Demographics

Around 5 patients with a background of the maximal endometrial thickness of < 7 mm were hired while administration of human chorionic gonadotropin (hCG), which resulted in fresh embryo transfer cancellation and unplanned embryos cryopreservation, and underwent frozen embryo transplantation in the Center for Reproductive Medicine of the 6th Affiliated Hospital of Sun Yat-sen University from 03/2014 to 06/2014. The age of these patients ranged from thirty-one years to thirty-nine years informed Dr. Amol Lunkad at the Indira IVF hospital in Pune.

Within conventional hormone replacement treatment (HRT) cycles, estradiol valerate at six mg/d was given on day 3 of the monthly menstrual cycle. The dosage is steadily increased every four days, as well as the maximal dosage, was 12 mg/d. almost all the five patients demonstrated inadequate thin endometrium (5.9-6.6 mm) on the day of supervision of progesterone, resulting in cycle cancelation. Hence to expel the intrauterine adhesion, the hysteroscopic examination was performed. Right now, there were no fibroids or polyps in diagnostic hysteroscopy. Chronically non-responsive thin endometrium resistant to standard therapy caused termination of embryo transfer. They then received management of Platelets rich plasma PRP, which had been approved by the Ethical Review Board from the 6th Affiliated Hospital of Sun Yat-Sen University and informed consent was obtained just before the study described Dr. Amol Lunkad at the Indira IVF and IUI clinic in Pune.

Hormone replacement therapy protocol and PRP planning

Estradiol valerate from 12 mg/d was provided on day 3 of the menstrual period. PRP was well prepared from autologous blood only by a modified method associated with Yamaguchi et al. On the tenth day of HRT routine, 15 ml of venous blood was drawn through the syringe pre-filled together with 5 ml of anticoagulant solution (ACD-A), and centrifuged immediately at 200g for 10 min. Typically the blood was divided into three layers: red blood cells at the bottom, cellular plasma within the supernatant and the buffy coat layer between them. And the plasma coating buffy coat has been collected to another tube and re-centrifuged at 500g for 10 minutes. The resulting pellet associated with platelets was mixed along with 1 ml of supernatant, and then 0.5-1 ml of Platelets rich plasma PRP had been obtained. It was Instilled into the uterine cavity immediately with Tomcat catheter (0.5-1 ml). Endometrial thickness was re-assessed seventy-two hours later. If the particular endometrial thickness was not necessarily satisfied, infusion of PRP was performed 1-2 times. Of five patients, just patient 2 received only one injection, and the leftover 4 underwent two infusions said Dr. Amol Lunkad at the Indira IVF and test tube baby clinic in Pune.

Therapy evaluation

Endometrial thickness had been measured at the thickest portion at the longitudinal axis of the uterus by a skilled ultra-sonographer. The particular thickness was measured three times to verify thin endometrium, plus the average from three or more measurements was documented. The primary endpoint was endometrial density measured in transvaginal sonography; the second endpoint has been clinical pregnancy after embryo transfer. Clinical pregnancy has been confirmed when an intrauterine gestational sac was determined by transvaginal ultrasonography, plus a rise in serum β-HCG was present stipulated Dr. Amol Lunkad at the Indira IVF and surrogacy center in Pune.

Results

The endometrial thickness increased at 48-72 hour after Platelets rich plasma PRP infusion in all the patients and attained > 7 millimeters when progesterone was administered. Patients 1, 2, and 5 underwent transfer with two blastocysts, patient three had transferred one blastocyst, and patient 4 got two cleavage-stage embryos. Cleavage-stage embryos were transmitted around the 3rd day right after progesterone administration, and blastocysts were assigned on the 5th day after progesterone administration informed Dr. Amol Lunkad at the Indira IVF which is known as the best IVF center in Pune.

Each of the five patients was pregnant. Patient numbered 2, and 5 had twins, as well as the remaining 3, had one intrauterine gestational sac. Patient 3 got a missed abortion in the 9th week of pregnancy. After the induced abortion, detection of chromosomes regarding the trisomy aneuploidy showed forty-five, XO. Pregnancies in the remaining four patients were usually progressing reported Dr. Amol Lunkad at Indira IVF which is one of the best IVF clinics in Pune.

Discussion

The main functions of platelets usually are protecting against acute blood loss and restoring vascular walls and adjacent tissues right after the injury. During wound recovery, platelets are activated and aggregate to discharge granules that contain growth factors, such as TGF-β, PDGF, IGF, VEGF, EGF, and FGF-2, which promote the inflammatory cascade and healing process. Platelets rich plasma PRP is described as a plasma fraction of autologous blood with the concentration of platelets 4-5 times above standard. It is fractionated plasma from autologous blood and includes concentrated platelets. With the particular functions of platelets, PRP is these days widely used in clinical scenarios, also in mucous tissues like eye and mouth, to improve tissue reconstruction. Additionally, the combined PRP and mesenchymal stem cells are widely studied in vitro. This specific study was to research the effectiveness of PRP in enhancing the endometrial regeneration and the natural regenerating capacity of the endometrium told Dr. Amol Lunkad at Indira IVF which is known as the best IVF hospitals in Pune.

Within this study, five individuals had extraordinarily poor endometrial quality, and the endometrium was non-responsive to standard estrogen therapy, leading to cycle cancellation, low chance of pregnancy, and more emotional distress. After employing PRP, the endometrial thickness was satisfactory in all the patients, who became expectant after ET. Of these people, the pregnancy was usually progressing in 4 ladies and one had skipped abortion disclosed Dr. Amol Lunkad at Indira IVF which is one of the best IVF treatment centers in Pune.

Since the diagnosis of implantation failure is sensitive, the clinical efficacy of PRP in this indication is usually difficult to assess. Nevertheless, the actual proliferative effect of PRP on the endometrium could be sonographically evaluated. Also, the endometrial thickness is an essential indicator for reproduction. Hence, the endometrial thickness had been employed to assess the effect of Platelets rich plasma PRP. The enhancement in the endometrial thickness inside this study is an excellent likelihood attributable to the infusion of PRP. Even though more studies are required to investigate to which degree PRP influences endometrium, and just how it enhances the reproduction, our findings recommend an endometrial infusion of Platelets rich plasma PRP can improve the endometrial thickness and aid the embryo implantation informed Dr. Amol Lunkad at Indira IVF which is one of the best IVF treatment centers in Pune.

Regrettably, one patient (patient 3) got a missed abortion because of chromosomal abnormality. Also, no evidence related to the infusion of PRP, and the other four cases experienced ongoing pregnancy. The PRP is prepared from autologous blood. Hence, you can find a minimum risk for disease transmission, immunogenic reactions, and malignancies. Using the landmark and long-term clinical knowledge on the application of Platelets rich plasma PRP in the oral-maxillary field, and thousands of patients have received this particular treatment so far, the application of PRP is considered secure. In this study, no infection or injury was observed assured Dr. Amol Lunkad at Indira IVF which is one of the best IVF hospitals in Pune.

Because we know, this research for the first moment reported the application of intrauterine infusion of PRP to enhance the endometrial thickness in women with a thin endometrium. Increase in endometrial thickness after injection of PRP in all the patients indicates that intrauterine infusion of PRP represents an excellent strategy for the thin endometrium with inadequate response to conventional therapy. The particular findings provide evidence concerning future randomized, managed tests with large sample size in this field concluded Dr. Amol Lunkad at Indira IVF which is one of the best IVF clinics in Pune.

Summary

This research was carried out to assess the effectiveness of PRP in the therapy of infertile women with a thin endometrium (≤ 7 mm) told the IVF doctors in Pune. When the subject is undergoing in vitro fertilization (IVF) with poor endometrial response still had thin endometrium which is less than seven millimeters after standard hormone replacement therapy (HRT) and had to cancel the embryo transfer cycle. Then an intrauterine infusion of PRP was performed. PRP was well prepared from autologous blood through centrifugation, and 0.5-1 ml of PRP was injected into the uterine cavity on the tenth day of HRT cycle. If endometrial thickness failed to increase 72 hours later, PRP infusion was done 1-2 times in each cycle. Embryos were transmitted when the endometrium thickness reached > 7 millimeters. Successful endometrial expansion and pregnancy were observed in the patients after PRP infusion. Intrauterine PRP infusion represents a new method for the thin endometrium with poor response. It was reported that platelet-rich plasma (PRP) was able to promote the endometrial growth and improve pregnancy outcome of patients with a thin endometrium.