Abstract
The crosstalk between a receptive endometrium and a functional blastocyst during human embryo implantation is crucial for conception. Because platelets rich plasma (PRP) with concentrated platelets 4-5 times higher than normal, when release of granules containing growth factors including VEGF, TGF, PDGF, IGF, and EGF, these factors involved for sub endometrial angiogenesis and endometrial receptivity. 44 women under the age of 40 were given antagonist ovarian stimulation treatments, the oocytes were harvested utilizing 2-D power doppler ultrasound guidance, then ICSI done for them. On the hCG day all had an intrauterine autologous PRP infusion. Power Doppler is utilized to measure endometrial thickness (EnT), pulsatility index (PI), and resistance index (RI) of sub endometrial arteries, as well as serum levels of VEGF and EGF were measured on the hCG day and ovum pickup (OPU). The ultrasound findings, on the hCG day compared to those of OPU in all women with intrauterine infused autologous PRP were highly significant (HS). The mean EnT, RI, PI, VEGF and EGF at OPU day was lower than that on hCG day in a HS manner, with (p < 0.001), (p < 0.001), (p = 0.047), (p < 0.001), and (p < 0.001) respectively. These characteristics were shown to be significantly and independently associated to intrauterine PRP infusion. After PRP injection, both growth factors serum levels (VEGF and EGF) increased, and ultrasonography sub-endometrial metrics such as EnT, RI, and PI changed as the thickness grew while vascular resistance decreased, and all considered as predictors of endometrial receptivity.
Highlights
Reproduction is mandatory for the persistence of all mammalian species
On the day of ovum PickUp (OPU), again, 2D Power Doppler ultrasound of endometrium-zone 2, and serum level of Vascular endothelial growth factor (VEGF) and epidermal growth factors (EGF) measured for all patients, Transvaginal ultrasound guided Oocyte retrieval done after triggering of ovulation with human chorionic gonadotropin (hCG) about 35-36 hrs
Blood sampling for VEGF and EGF, at day of trigger and day of OCR, and according to the number and grading of the embryos, patients were prepared for the transfer
Summary
Reproduction is mandatory for the persistence of all mammalian species. Rendering to World Health Organization (WHO [1]) ‘‘a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse,’’(Szamatowicz and Szamatowicz [2]). Rendering to World Health Organization (WHO [1]) ‘‘a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse,’’. Implantation failure remains an unsolved issue in assisted reproductive technologies (ART), where good quality embryos are transplanted as a standard of care. What we are dealing with is the fact that implantation failure in ART is widespread, and we do not have any evidence-based therapy remedies for it. Practitioners are frequently compelled to recommend treatments that are mostly empirical, based on some biological rationale but with little clinical proof to back them up (Dieamant, et al [3]). It is widely known that blastocysts cannot attach to an immature endometrium, resulting in unsuccessful implantation even when “good quality” embryos are transferred (Elsokkary, et al [4])
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