Intrauterine Infusion Research Articles

Autologous platelet-rich plasma improves the endometrial thickness and live birthrate in patients with recurrent implantation failure and thin endometrium.

PurposeThe aim of this study was to evaluate the effects of intrauterine platelet-rich plasma (PRP) infusion on endometrial thickness and pregnancy outcomes in a population of patients with either recurrent implantation failure (RIF), thin endometrium (TE), or both (RIF + TE)MethodsThis retrospective study included patients attending the CReATe Fertility Centre between October 2018 and July 2021 who received intrauterine PRP infusion to prepare the endometrium for frozen embryo transfer. PRP was prepared from 21 cc of whole blood using the 2-step centrifugation method to yield 0.5–0.75 cc of concentrated platelets. Endometrial thickness was measured before infusion and within 72 h after infusion. All embryos transferred were tested for genetic abnormalities using next-generation sequencing.ResultsA total of 85 patients, 133 cycles, and 211 infusions were included. The majority of patients (56.5%) were diagnosed with RIF, some with TE (27.0%), and the remainder with both RIF and TE (16.5%). The majority of patients received one PRP infusion per cycle (55%). The endometrial thickness significantly increased across all diagnoses with a significant increase of 1.0 mm (0.5–1.7), which was also significantly greater than in previous cycles. The clinical pregnancy rate per embryo transfer after intrauterine PRP infusion was significantly greater compared to previous cycles (37% vs 20%, odds ratio 2.2) as was the live birth rate (19% vs 2%, odds ratio 11.6).ConclusionOur study suggests that PRP should be considered a noninvasive front-line therapy for improving endometrial thickness and implantation in patients with RIF, a TE, or both.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10815-022-02505-0.

The endometrial transcriptomic response to pregnancy is altered in cows after uterine infection.

Pregnancy induces changes in the transcriptome of the bovine endometrium from 15 days after insemination. However, pregnancy is less likely to occur if cows had a postpartum bacterial infection of the uterus, even after the resolution of disease. We hypothesized that uterine bacterial infection alters the endometrial transcriptomic signature of pregnancy after the resolution of disease. To examine the endometrial transcriptomic signature of pregnancy, cows were inseminated 130 days after intrauterine infusion of pathogenic Escherichia coli and Trueperella pyogenes, subsequently endometrium was collected 16 days after insemination for RNA sequencing. We found 171 pregnancy regulated genes in cows 146 days after bacterial infection. When comparing our findings with previous studies that described the endometrial transcriptomic signature of pregnancy in healthy cows, 24 genes were consistently differentially expressed in pregnancy, including MX1, MX2 and STAT1. However, 12 pregnancy regulated genes were found only in the endometrium of healthy cows, including ISG15 and TRANK1. Furthermore, 28 pregnancy regulated genes were found only in the endometrium of cows following bacterial infection and these were associated with altered iNOS, TLR, and IL-7 signaling pathways. Although 94 predicted upstream regulators were conserved amongst the studies, 14 were found only in the endometrium of pregnant healthy cows, and 5 were found only in cows following bacterial infection, including AIRE, NFKBIA, and DUSP1. In conclusion, there were both consistent and discordant features of the endometrial transcriptomic signature of pregnancy 146 days after intrauterine bacterial infusion. These findings imply that there is an essential transcriptomic signature of pregnancy, but that infection induces long-term changes in the endometrium that affect the transcriptomic response to pregnancy.

Intrauterine infusion of blood serum of dromedary camel improves the uterine health and fertility in high producing dairy cows with subclinical endometritis

The blood serum of dromedary camels contains a unique type of antibodies with a high potency to neutralize toxins and to identify and inactivate some bacterial pathogens. The present study was designed to examine changes in the endometrial histology of cows with no subclinical endometritis (SE) (experiment 1) and changes in the uterine cytology and endometrial mRNA expression of COX2, IL-1β, IL-8, and iNOS following intrauterine administration of DCBS in cows with SE as compared to different common treatments (experiment 2). In addition, the effects of the intrauterine administration of DCBS were examined on the pregnancy rate in dairy cows with SE (experiment 3). DCBS did not induce any histological reactions in the bovine endometrium. The mean ( ± SE) percentage of PMNs after intrauterine infusion of Pen-Strep, DCBS and double DCBS in cows with SE differed as compared to cows treated with PGF2α and no treated cows with SE (1.47 ± 0.87; 1.43 ± 1.08 and 1.31 ± 0.23 vs 3.00 ± 0.43 and 3.5 ± 0.75, P < 0.05, respectively) in experiment 2. The mRNA expression of COX2, IL-1β, and iNOS was reduced (P < 0.05) after treatment with Pen-Strep, DCBS and double DCBS as compared with no treated-cows with SE. The pregnancy rate after the first AI was tended to be higher (49.2 vs 39.0%), while the overall pregnancy rate was greater (P < 0.05) in cows with SE when treated with DCBS as compared to the Pen-Strep group (76.9 vs 61.0%) in experiment 3. In conclusion, serum of dromedary camel, as a non-antibiotic preparation, can improve the uterine health and fertility when used for the treatment of bovine SE.

Effect of autologous platelet-rich plasma for treatment of recurrent pregnancy loss: a randomized controlled trial.

ObjectiveRecurrent pregnancy loss (RPL) is a fertility problem for which no exact mechanism of abortion or efficient treatment has been described. This study was conducted between 2018 and 2019 to investigate the effectiveness of autologous platelet-rich plasma (PRP) in improving the live birth rate of women with RPL who required in vitro fertilization (IVF).MethodsA total of 63 patients with at least two previous pregnancy losses and no specific cause detected for the RPL were included and randomly assigned into two groups (PRP and control). Intrauterine infusion of 0.5 mL of autologous PRP was performed 48 hours before embryo transfer in the PRP group. Women in the control group received standard treatment.ResultsForty patients completed the study. The baseline and cycle characteristics of the participants did not differ significantly between the PRP and control groups. The clinical pregnancy rate was higher in the PRP group (35% vs. 20%, P=0.288). The live birth rate was 15% in the PRP group, but no live births were recorded in the control group (P=0.231).ConclusionThis is the first study to show that intrauterine infusion of PRP in patients with RPL who undergo IVF may increase the chance of live birth.

Intrauterine infusion of clinically graded human umbilical cord-derived mesenchymal stem cells for the treatment of poor healing after uterine injury: a phase I clinical trial

BackgroundIntrauterine adhesion and cesarean scar diverticulum are the main complications of poor healing after uterine injury. Human umbilical cord MSCs transplantation has been regarded as the most potential treatment in the clinic, the safety and efficacy of which in the clinic, however, remains unclear.MethodsIn this study, ten patients were enrolled: six with intrauterine adhesion and four with cesarean scar diverticulum. All the patients were injected with human umbilical cord MSCs twice into the uterus. Beside the chest X-ray, ECG and abdominal ultrasound, many laboratory tests including blood routine, liver and renal function, ovarian function, tumor biomarkers, and immune function were used to estimate the safe after stem cell transplanted. In addition, the efficacy of stem cell transplanted was shown by the endometrial thickness, the volume of the uterus, and cesarean scar diverticulum based on 3D ultrasound imaging.ResultsWe found that all results of these laboratory tests were normal in these enrolled patients before and after cell injection. Meanwhile, the results of the chest X-ray and ECG were also normal in the treatment process. The abdominal ultrasound showed that the size of the left and right kidneys was inconsistent in one patient after cell therapy, while those of other patients were normal. In addition, endometrial thickness, the volume of the uterus, and cesarean scar diverticulum showed an improving tendency, but no significant difference was noted.ConclusionIn summary, intrauterine injection of clinically graded human umbilical cord MSCs was safe for poor healing after uterus injury.Trial registration NCT03386708. Registered 27 December 2017, https://clinicaltrials.gov/ct2/show/NCT03386708?cond=CSD&cntry=CN&draw=2&rank=2

Effectiveness of Ozone Therapy in The Treatment of Endometritis in Mares

Endometritis is defined as inflammation of the endometrium that may be acute or chronic, infectious, or non-infectious. Endometritis is an important cause of subfertility in mares. Considering the antimicrobial characteristics, immune-stimulating ability, and low cost of ozone (O3) therapy, we aimed to evaluate the effectiveness of intrauterine O3 therapy as an alternative treatment for endometritis in mares. Twenty-five mares with a known reproductive history of uterine infection and inflammation were allocated into three groups: Group 1 (control; n = 7), uterine lavage with Ringer's lactate solution; Group 2 (O3-gas; n = 9), uterine lavage with Ringer's lactate solution followed by uterine insufflation with O2-O3 gas mixture containing 40 µg O3 mL−1 for 10 minute; and Group 3 (O3-oil; n = 9), uterine infusion of ozonized sunflower oil. Uterine inflammation was evaluated through a uterine cytological examination (cytobrush) and uterine culture (swab) for microbiological content before and after all treatments. In assessments of uterine cytology, the average number of neutrophils/field changed from 9.14 ± 3.02 to 7.71 ± 3.59 in the control group, from 10.67 ± 3.84 to 2.89 ± 3.59 in the O3-gas group, and from 6.44 ± 2.79 to 6.55 ± 7.18 in the O3-oil group post-treatment. The pre- and post-treatment findings in the mares treated with ozonized gas were significantly different (P < .05), unlike the findings for the mares in the control and O3-oil groups. All mares (25/25) showed a positive uterine culture before treatment. After treatment, the percentage of mares showing positive culture results was 57%, 11%, and 22% in the control, O3-gas, and O3-oil groups, respectively. Our results showed the effectiveness of two groups (O2-O3 gas mixture and ozonized sunflower oil) for the treatment of uterine infections in mares. Thus, direct intrauterine O3 gas infusion has been shown to be effective in treating endometritis in mares, reducing both inflammation and uterine infection.

Intrauterine administration of G-CSF for promoting endometrial growth after hysteroscopic adhesiolysis: a randomized controlled trial.

Does intrauterine infusion of granulocyte colony-stimulating factor (G-CSF) prevent adhesion reformation and promote endometrial growth after hysteroscopic adhesiolysis? Intrauterine perfusion of G-CSF can increase endometrial thickness but does not prevent the recurrence of intrauterine adhesions (IUAs) in patients with Asherman syndrome (AS) after surgery. Intrauterine infusion of G-CSF has been used in attempts to treat patients with recurrent miscarriage and an idiopathic thin endometrium for either fresh or frozen-thawed embryo transfer cycles but without uniform efficacy. There have been no reports on the effect of G-CSF on the recurrence of IUAs, endometrial regrowth or pregnancy results in specific populations with AS. This two-center prospective double-blind randomized controlled trial ran between April 2016 and August 2021. In it, 245 patients with moderate to severe AS were randomized to G-CSF and control groups at a 1:1 ratio; 229 women were included in the adhesion recurrence analysis; and 164 patients were analyzed for pregnancy outcomes. All eligible patients received the first hysteroscopic adhesion separation and balloon placement procedure. Patients who met our inclusion and exclusion criteria were randomized after surgery. These patients returned for balloon removal and underwent intrauterine perfusion with 300 µg (1.8 ml) G-CSF or 1.8 ml normal saline according to randomization at 7 days after surgery. A second-look hysteroscopy was carried out 1-2 months later. The primary outcome was the rate of formation of new adhesions at the second hysteroscopy. The secondary outcomes included endometrial thickness in the periovulatory period after surgery, as well as the clinical pregnancy and live birth rates. Age, menstrual cycle characteristics, pregnancy history and IUA score before surgery were similar between groups. There were no statistically significant differences in the adhesion reformation rate or median adhesion score reduction. However, G-CSF perfusion significantly improved endometrial thickness (7.91 ± 2.12 mm vs 7.22 ± 2.04 mm; P = 0.019, 95% CI for difference: -1.26 to -0.12), as well as cumulative pregnancy and live birth rate over time (P = 0.017 and P = 0.042). Furthermore, multivariate logistic regression analysis showed that postoperative endometrial thickness was an independent prognostic factor for pregnancy and live birth rates. These results cannot be extended to older patients or those without AS, as our subjects had moderate or severe AS and were aged <40 years. The low number of patients included in the fertility analysis could lead to biased results. Intrauterine perfusion of G-CSF could be an effective adjuvant therapy for patients with AS to increase endometrial thickness. This study was supported by grants from the National Key Research and Development Program of China (2018YFC1004800), the National Natural Science Foundation of China (82001624 and 81871209), the Natural Science Foundation of Zhejiang Province (LQ20H040004) and the provincial and ministerial construction project of Zhejiang Province (2017 WKJ-ZJ-1721). The authors declare that they have no conflicts of interest regarding this work. ClinicalTrials.gov (NCT02855632). 4 March 2016. 13 April 2016.

Ovarian steroids modulate the systemic inflammatory response OF COWS challenged with lipopolysaccharide (LPS) intrauterine infusion

Postpartum uterine infections of dairy cows promote a local and systemic inflammation and interfere with reproductive efficiency. The aim of this study was to evaluate the effect of steroid hormones including progesterone (P4) and estradiol (E2) on the systemic inflammatory response of cows after being challenged with an intrauterine infusion of lipopolysaccharide (LPS). For this, a hemogram and serum dosage of haptoglobin (Hp) in eight primiparous Gir cows ovariectomized were performed on day (day 0) and after 24 h (day +1). Four cows (n = 4) were challenged (day 0) with 20 mL of 0.9% NaCl + 12.5 μg/kg LPS, and four cows (n = 4) were challenged (day 0) with 20 mL of 0.9% NaCl. For this, the study was divided in four experimental groups as: (1) Control group: without any hormonal treatment before day 0; (2) Group 24 h - E2: 1 mg of estradiol benzoate 24 h before (day −1); (3) Group 24 h - P4: 2.0 g of P4 device 24 h before (day −1); (4) Group 14 d - P4: 2.0 g of P4 device 14 days before (day −14). In the systemic response to LPS, there was an increase in Hp (control group; 24 h - P4 group; 14 d - P4 group), and on day +1 the Hp of 14 d - P4 group was higher when compared to the other groups. On day 0, the 14 d - P4 group had an increase in circulating leukocytes and lymphocytes cells than the control group (P < 0.01). On day +1 after LPS-challenge the 14 d - P4 group showed a decrease in circulating lymphocytes, eosinophils, and monocytes (P < 0.05). A neutrophilia with left shift in the two treatments with P4 (day +1), in addition to a thrombocytopenia and lower platelets compared to the 24 h - E2 group (P < 0.05) (day 0) were recorded. It was concluded that ovariectomized cows challenged with LPS, previously submitted to steroid hormones induce a systemic inflammatory response. Also, the systemic response is more intense after previous prolonged exposure to P4 and less intense after exposure to E2. This study provided important information relating the effect of ovarian steroids on the systemic inflammatory response of cows challenged with intrauterine LPS.

The efficiency of intrauterine infusion of platelet-rich plasma in the treatment of acute endometritis as assessed by endoscopic, Doppler, oxidative, immunohistochemical, and gene expression alterations in jennies

This study used autologous platelet-rich plasma (PRP) to treat acute endometritis in jennies with follow-up for alterations in uterine hemodynamics, endoscopic, immunohistochemistry, oxidant/antioxidant imbalance, pro-inflammatory regulatory molecules, and transmembrane mucin expressions. Ten jennies suffering from endometritis (acute type; n = 10) were included in the study. PRP was prepared from each animal and two intrauterine infusions one week apart were administrated. Examination and follow-up were done physically, ultrasonographically, endoscopically and samples were taken for histopathology, immunohistochemistry, and bacteriological examination. Blood and uterine fluid samples were taken to estimate biochemical and oxidative stress alterations. Expression of TRAF6 and MUC1 genes was investigated in uterine fluid, at days −1 (day of diagnosis establishment), 7, 14, and 21. Uterine bacteriological examination showed a decrease in bacterial isolates after PRP treatment. The uterine thickness and uterine vascular perfusion as illustrated by color Doppler ultrasonography were significantly decreased in jennies treated by PRP. Uterine spectral wave pattern showed a significant linear increase in pulsatility index only. Three weeks after first PRP treatment, white light endoscopic examination revealed normal uterine body mucosa and uterine horn folds. A high nuclear factor (NF-κB) expression was seen in the mononuclear cells. A significant reduction in oxidative stress biomarkers in both serum and uterine fluid was recorded after PRP treatment. The TRAF-1 gene expression significantly decreased gradually after intrauterine PRP infusion. The MUC-1 gene expression significantly decreased gradually after intrauterine PRP infusion. Both genes were within normal levels by week 3. Endometritis in jennies is associated with an oxidative process, alterations in serum biochemical parameters, Doppler indices, endoscopic appearance, high NF-κB expression, and upregulation of TRAF-1 and MUC-1 expressions. Two intrauterine infusions of autologous PRP restored normal endometrial appearance after acute endometritis.

Nrf2/HO-1 pathway is involved the anti-inflammatory action of intrauterine infusion of platelet-rich plasma against lipopolysaccharides in endometritis

Objective(s) Endometritis is the inflammatory response of the uterine lining which is linked to infertility. Administration of platelet-rich plasma (PRP) represents a well-recommended strategy for the treatment of endometrium-associated infertility. In this study, we set to characterize the role and molecular mechanism of PRP intrauterine infusion in mice with endometritis. Methods A mouse model of endometritis was established using lipopolysaccharide (LPS). Mouse endometrial epithelial cells were obtained in primary culture. PRP-treated cells were assayed for proliferative and apoptotic activities. Moreover, iNOS expression and chemokine and inflammatory factor contents in cells were assessed using RT-qPCR and ELISA. The mice were subjected to PRP intrauterine infusion. The expression of genes related to uterine development was analyzed by qPCR and the ki-67 content and caspase-3 activation in endometrial tissues were examined by immunohistochemistry. Finally, the Nrf2/HO-1 pathway activity in tissues was examined by Western blot. Results LPS induced inflammatory cell recruitment and tissue damage in the endometrium of mice, along with significantly increased levels of inflammatory and chemokine factors. PRP significantly enhanced endometrial epithelial cell activity, decreased apoptosis, and reduced inflammatory factor secretion. In addition, PRP intrauterine infusion significantly increased the expression of genes related to uterine development, promoted tissue proliferation, decreased apoptosis, and diminished inflammatory response in endometrial tissues of mice. PRP intrauterine infusion significantly elevated Nrf2/HO-1 pathway activity in endometrial epithelial cells and tissues. Conclusion PRP intrauterine infusion significantly inhibited endometrial cell injury and alleviated the inflammatory response through activating the Nrf2/HO-1 pathway.

Effect of intrauterine administration of human chorionic gonadotropin one day before fresh blastocyst transfer on clinical outcomes: a quasi-experimental study.

Introductionembryo implantation is a crucial step for assisted reproductive technology (ART) achievement. Human chorionic gonadotropin (hCG) is one of the main regulators of the implantation process. Studies focusing on the impact of intrauterine hCG infusion at the time of embryo transfer on clinical ART outcomes have shown controversial results, mainly at blastocyst stage. In this study, we aimed to investigate whether intrauterine hCG infusion one day before human blastocyst transfer in fresh invitro fertilization (IVF) cycles enhances implantation and pregnancy rates.Methodsa total of 174 subfertile women undergoing autologous fresh blastocyst transfer were enrolled in this randomized prospective study. Patients were randomly divided into three groups; group 1 (n = 54) and group 2 (n = 59) received an intrauterine injection of respectively 500 IU and 1000 IU of hCG one day before blastocyst transfer and the control group (n= 61) did not receive any intrauterine injection. The pregnancy and implantation rates were compared between the three study groups.Resultssignificant difference was found between the study groups. The bio chemical pregnancy rates were 25.9%, 30.5% and 29.5%, the clinical pregnancy rates were 24.1%, 27.1% and 27.9% and the implantation rates were 14.9%, 17.9% and 18.7% respectively in group 1,2 and control group.Conclusionour results have shown that clinical outcomes in fresh IVF cycles cannot be improved through intrauterine hCG administration one day prior to blastocyst transfer, neither with 500 IU of hCG nor with a higher dose of 1000 IU of hCG.

Intrauterine infusion of autologous Platelet-rich plasma before frozen embryo transfer in patients with prior implantation failure: A randomized controlled study

Intrauterine infusion of autologous Platelet-rich plasma before frozen embryo transfer in patients with prior implantation failure: A randomized controlled study

Effects of Autologous Platelet-Rich Plasma in women with repeated implantation failure undergoing assisted reproduction.

ObjectiveRepeated implantation failure (RIF) is a major challenge in reproductive medicine. On the other hand, there has not yet been established a confirmed outcome regarding the usage of platelet-rich plasma (PRP) in women undergoing intracytoplasmic injection (ICSI) or in-vitro fertilization (IVF); hence, the objective of this study was to evaluate the effect of the intrauterine infusion of PRP on pregnancy outcomes in women undergoing ICSI.MethodsIn this prospective double-blind clinical trial, 100 women with at least two previous unexplained RIF, who were candidates for frozen-thawed embryo transfer, were allocated into two groups. One subgroup of patients was treated by intrauterine infusion of PRP (0.5CC, contained platelet 4-5 times more than a peripheral blood sample, which was performed 48 hours before blastocyst transfer) and the other subgroup was treated by intrauterine catheterization only. We compared the implantation rates between the two groups.ResultsThe pregnancy rate was 20% in the intervention subgroup, while in the control subgroup it was 13.33%; therefore, there was a significant statistical difference between the two groups.ConclusionsAccording to this paper, PRP could be successful in improving the pregnancy outcome in RIF patients, and we highly recommend other studies with larger samples to confirm the PRP therapy efficacy in RIF patients.

Lyophilized Platelet-rich plasma for the management of thin endometrium and facilitation of in-vitro fertilization.

Adequate endometrial thickness has been considered an important parameter for hormonal response and blastocyst implantation in assisted reproduction therapies. While there is no consensus on the exact thickness of the endometrium considered 'adequate,' a thin endometrium (<7mm) has been associated with compromised outcomes in assisted reproduction therapies. Platelet-rich plasma (PRP), which is a concentrate obtained from peripheral blood, is a rich source of growth factors that play important roles in various cellular processes. The objective is to utilize lyophilized PRP (LPRP) to increase the thickness of the endometrium and enhance the outcomes of embryo transfer in women with poor response to previous in-vitro fertilization procedures. This study enrolled nine women between 23 and 42 years of age, with a thin endometrium, who had undergone multiple previous unsuccessful assisted reproduction procedures. All patients underwent intrauterine infusion of LPRP, followed by frozen-thawed embryo transfer after 2-3 days. Endometrial thickness was assessed by ultrasound 2 weeks after LPRP infusion, which showed improved thickness in all patients (range, 0.7-2.2mm). Clinical pregnancy occurred in all patients and eight out of nine patients are currently between 9 weeks and 27 weeks of gestation. Twin fetal heartbeats were not detected at the eighth week in one patient. Infusion of LPRP was found to be beneficial to increase endometrium thickness in all patients. This regenerative technique could be considered to enhance the outcomes of assisted reproduction techniques in a minimally-invasive manner, without any side effects.

Effect of intrauterine infusion of two cephalosporins, ceftazidime and cephapirin, on uterine bacterial load and uterine horn diameter in bovine subclinical endometritis

This study aimed to evaluate the effect of intrauterine infusion of ceftazidime and cephapirin on uteri­ne bacterial load and uterine horn diameter in bovine subclinical endometritis. At 7-8 weeks postpartum, a total of 122 cows suffering from subclinical endometritis were divided into three groups. Group I cows were intrauterinely (IU) infused with 2 g ceftazidime diluted with 50 mL saline; group II cows were IU infused with 2 g cephapirin diluted with 50 mL saline; and group III cows were kept as untreated control. Vaginal examination, ultrasonography and bacterial examination were done before treatment programme and later repeated twice at 10-day intervals. Staphylococcus spp., Klebsiella spp., Streptococcus spp., Escherichia coli and Proteus spp. were isolated. After the end of the treatment programme, proportions of cows infected with Staphylococcus spp. and Streptococcus spp. were significantly (P&lt;0.05) decreased in ceftazidime and cephapirin groups. However, proportions of cows infected with Escherichia coli were significantly (P&lt;0.05) decreased in the ceftazidime group only. Uterine bacterial loads in ceftazidime and cephapirin groups were significantly decreased (P&lt;0.05). Mean uterine horn diameters in ceftazidime group (2.44±0.03 cm) became significantly lower (P&lt;0.05) than those in cephapirin (2.70±0.04 cm) and control (3.06±0.06 cm) groups. Conception rate in ceftazidime group (80.95%) was significantly (P&lt;0.05) higher than rates recorded in cephapirin (64.00%) and control (26.67%) groups. In conclusion, ceftazidime and cephapirin decreased uterine bacterial load. Moreover, ceftazidime significantly reduced uterine horn diameter compared to the other groups and was associated with significantly higher conception rate. Thus, ceftazidime is recommended for treatment of subclinical endometritis in dairy cows.

Effectiveness of Intrauterine Infusion of Autologous Platelet-Rich Plasma in the Treatment of Thin Endometrium of Infertile Women

One of the key factors in implantation and pregnancy is endometrium. Sufficiently great percentage of in vitro fertilization failure is because of the endometrial receptivity therefore, high quality embryo and adequate receptive endometrial growth are important for successful implantation. Platelet rich plasma has beneficial effect in advancement of endometrial thickness for women with thin endometrial thickness. PRP can be used in various medical conditions including patients with refractory endometrium as a complementary therapy to conventional treatment.&#x0D; Aim: To determine the effectiveness of intrauterine infusion of autologous platelet-rich plasma in the treatment of thin endometrium of infertile women.&#x0D; Objectives:&#x0D; &#x0D; To identify infertile female patients with inadequate endometrial growth (less than 7 mm) in the past frozen embryo transfer (FET) cycles despite standard treatments.&#x0D; To observe intrauterine infusion of autologous platelet-rich plasma (PRP) in these infertile female patients with thin endometrium.&#x0D; To determine the effectiveness of intrauterine infusion of autologous PRP in the treatment of thin endometrium of infertile women during In vitro fertilization (IVF).&#x0D; &#x0D; Methods: It is a prospective observational study. Present study will be carried out with 30 patients. Women having inappropriate endometrial thickness of less than 7 mm, in past FET cycles will be included. Sonographic machine will be used; to measure endometrial thickness by an expert Gynecologist, where thickest part of uterus will be measured in longitudinal axis. &#x0D; Expected Results: It is expected that intra uterine infusion of PRP will be effective in thickening of endometrial wall in patients with thin endometrium. Once the results are satisfactory it can be helpful for endometrial preparation in reproduction techniques.&#x0D; Conclusion: Present study is purposed to testify PRP as a novel method for advancement of reproductive medicine, it will be helpful to overcome with the issues such as inadequate thickness of endometrium, poor response to conventional therapy and increase clinical pregnancies and live births positively.

Effect of intrauterine caffeine infusion on the intrauterine environment and conception rate after artificial insemination with sex-sorted semen in lactating dairy cows

乳牛性選別精液を用いた人工授精（AI）では，経産牛の低受胎率が問題となっている．我々は，ブタにおいて，カフェイン（Caf）添加希釈液を用いてAIを行うと，AI後の子宮内白血球数の増加が抑制され，受胎率が向上することを報告した．本研究では，乳牛における深部注入器を用いた性選別精液AI体系においてCaf添加注入液の効果について検討した．Caf無添加区では，AI後の子宮内白血球数がAI未実施（対照）区に比べて有意に多かったが，Caf添加区とAI未実施（対照）区との間では，その数に有意差は認められなかった．AI後の乳牛の受胎率は，空気注入（対照）区の41.7%に対して，Caf添加区では47.1%であった．以上の結果から，性選別精液の乳牛へのAIにCaf添加注入液を使用すると，AI後の子宮内白血球数の増加を軽減できる可能性が示唆された．

Effect of Autologous Platelet-Rich Plasma (PRP) Treatment on Endometrial Receptivity in ICSI cases

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 &lt; 0.001), (p &lt; 0.001), (p = 0.047), (p &lt; 0.001), and (p &lt; 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.

The Effect of Intrauterine Infusion of Peripheral Blood Mononuclear Cells Culture on Subendometrial Blood Flow in Patients Undergoing ICSI Cycles

In recent years increasing evidence proposed that local immune cells at implantation site have largely contributed to embryo implantation. The intrauterine infusion of activated peripheral blood mononuclear cells culture 2 days before embryo transfer can enhance the implantation. One of the methods used to evaluate the endometrial receptivity is by assessing the sub endometrial blood flow. A total of 67 infertile women (30) women receives intrauterine non-invasive insemination of peripheral blood mononuclear cells (PBMC) culture 2 days before embryo transfer representing the PBMC test group, and (37) women without receiving any cell as Non-PBMC group. The cultured PBMC are administered into the uterine cavity of the patients. 2 days later, embryos are transferred into the uterine cavity. Endometrial thickness and sub-endometrial blood flow measurements are taken for all cases on trigger and embryo transfer days. On embryo transfer day there was no significant difference (p = 0.770) in mean endometrial thickness between the PBMC group and Non-PBMC group. There was a significant difference (p&lt; 0.001) in the mean resistive index; the level being lower in the PBMC group. Moreover, there was a significant difference (p&lt; 0.001) in the mean pulsatility index. Regarding all enrolled women, the pregnancy rate of 25.4 %, the rate was higher in the PBMC group in comparison with the Non-PBMC group, 43.3 % versus 10.8 %, respectively and the difference was significant (p = 0.002). The use of PBMC culture can improve sub-endometrial.

The Effect of Intrauterine Infusion of Peripheral Blood Mononuclear Cells Culture on Subendometrial Blood Flow in Patients Undergoing ICSI Cycles

In recent years increasing evidence proposed that local immune cells at implantation site have largely contributed to embryo implantation. The intrauterine infusion of activated peripheral blood mononuclear cells culture 2 days before embryo transfer can enhance the implantation. One of the methods used to evaluate the endometrial receptivity is by assessing the sub endometrial blood flow. A total of 67 infertile women (30) women receives intrauterine non-invasive insemination of peripheral blood mononuclear cells (PBMC) culture 2 days before embryo transfer representing the PBMC test group, and (37) women without receiving any cell as Non-PBMC group. The cultured PBMC are administered into the uterine cavity of the patients. 2 days later, embryos are transferred into the uterine cavity. Endometrial thickness and sub-endometrial blood flow measurements are taken for all cases on trigger and embryo transfer days. On embryo transfer day there was no significant difference (p = 0.770) in mean endometrial thickness between the PBMC group and Non-PBMC group. There was a significant difference (p&lt; 0.001) in the mean resistive index; the level being lower in the PBMC group. Moreover, there was a significant difference (p&lt; 0.001) in the mean pulsatility index. Regarding all enrolled women, the pregnancy rate of 25.4 %, the rate was higher in the PBMC group in comparison with the Non-PBMC group, 43.3 % versus 10.8 %, respectively and the difference was significant (p = 0.002). The use of PBMC culture can improve sub-endometrial.