#144 : Randomized Controlled Trial Evaluating Efficacy of Autologous Platelet-Rich Plasma Therapy for Patients with Recurrent Implantation Failure in Frozen-Thawed Embryo Transfer After PGT-A

Abstract

Background and Aims: Despite keen development of ART, recurrent implantation failure (RIF) remains a challenging dilemma for fertility specialists. As it contains significant growth factors involved in delicate process of implantation, platelet–rich plasma (PRP) therapy should promote endometrial receptivity and improve ART. Objective: To evaluate if the intrauterine perfusion with autologous PRP enhances frozen-thawed embryo transfer effectiveness in patients with RIF after PGT-A. Methods: Study type: Interventional. Design: randomized controlled study Intervention Model: Parallel Assignment Masking: open label After obtaining institutional review board approval, 232 women aged 28-42 years were involved. Matching criteria: RIF, normal karyotype, absence of uterine factors of infertility, availability of euploid embryos after PGT-A (NGS). 2 groups of patients: study group (N = 118): single IP with 2.0 ml of autologous PRP on day 10-11 of menstrual cycle; Control group: no therapy (N = 114). Endometrium preparation was carried out according to standardized protocol. Primary outcome measure was clinical pregnancy rate. Secondary outcome measures were pregnancy loss rate, endometrial thickness and adverse event. Results: The clinical pregnancy rate was higher in the study group (63.55% vs 38.59%) ([Formula: see text]2=14.462, OR=2.775, 95% CI 1.630 - 4.722, p<0,001). The endometrium thickness before intervention didn’t between groups (7.3 vs 7.4 mm), however, endometrium thickness measured just before embryo transfer was significantly higher in the study group (10.5 vs 8.4 mm, Student’s t-test value: 11.87; number of degrees of freedom f=230; Critical value of Student’s t-test=1.972, at significance level [Formula: see text]= 0.05). The pregnancy rate loss did not differ between groups ([Formula: see text]2=0.033, OR=0.908, 95% CI 0.324 – 2.546, p>0,05). No adverse event was noted. Conclusions : – The PRP intrauterine perfusion should be considered perspective, safe and cost-effective therapy method for patients with RIF. – PRP does not influence on pregnancy loss rate – Meta-analysis is required. Support: None