背景:薄型子宫内膜(TE)是临床实践中女性不孕的常见原因。富血小板血浆(PRP)疗法成为薄型子宫内膜的一种新的治疗方法;然而,其临床应用仍存在争议。本荟萃分析旨在通过相关随机对照试验(RCTs)评估子宫内自体PRP输注对子宫内膜薄型患者的治疗效果。
方法:我们系统地搜索了从成立到2024年6月在PubMed等数据库中以英文发表的研究,科克伦图书馆,Embase,WebofScience,和MEDLINE。搜索词包括\"富血小板血浆,“薄薄的子宫内膜,“\”子宫内膜厚度,“\”不孕症,\"\"怀孕,\"\"复制,\"和\"不良反应\"。通过搜索确定的随机对照试验进行系统评价和荟萃分析,并使用基于异质性的固定效应或随机效应模型对数据进行分析。
结果:共纳入8项RCTs,涉及678例子宫内膜薄型患者。与对照组相比,接受PRP输注的患者的子宫内膜厚度明显优于对照组(MD:1.23,95CI:0.87至1.59,P=0.000),临床妊娠率(RR:2.04,95CI:1.52~2.76,P=0.000),活产率(RR:2.46;95CI:1.57至3.85,P=0.000),周期取消率(RR:0.46,95CI:0.23至0.93,P=0.000),胚胎着床率(RR:2.71;95CI:1.91~3.84,P=0.000)。自然流产率无统计学意义(RR:0.85,95CI:0.40~1.78,P=0.659),两组间化学妊娠率(RR:1.84,95CI:0.72~4.72,P=0.204)和子宫内膜血管改善率(RR:1.10;95CI:0.89~1.38,P=0.367)。这项研究的局限性包括,我们只包括了文学研究的单一术语,样本量和异质性可能导致标准偏差。
结论:宫内灌注PRP可能是子宫内膜薄型的一种安全有效的治疗方法。进一步的高品质,大样本,需要随机对照试验来验证我们结果的可靠性.
背景:审查协议已在PROSPERO上注册,注册号为CRD42023490421,并且在注册时没有对提供的信息进行任何修改。
BACKGROUND: Thin endometrium (TE) is a common cause of female infertility in clinical practice. Platelet-rich Plasma (PRP) therapy becomes a novel treatment for thin endometrium; however, its clinical application remains controversial. This meta-analysis aims to evaluate the therapeutic effects of intrauterine autologous PRP infusion in women with thin endometrium through relevant randomized controlled trials (RCTs).
METHODS: We systematically searched studies published in English from inception until June 2024 in databases such as PubMed, The Cochrane Library, Embase, Web of Science, and MEDLINE. Search terms included \"Platelet-Rich Plasma,\" \"thin endometrium,\" \"endometrial thickness,\" \"infertility,\" \"pregnancy,\" \"reproduction,\" and \"adverse reactions\". RCTs identified through the search were subjected to systematic review and meta-analysis, and data were analyzed using fixed-effects or random-effects models based on heterogeneity.
RESULTS: Eight RCTs involving 678 patients with thin endometrium were included. Patients receiving PRP infusion demonstrated significantly superior outcomes compared to the control group in endometrial thickness (MD: 1.23, 95%CI: 0.87 to 1.59, P = 0.000), clinical pregnancy rate (RR: 2.04, 95%CI: 1.52 to 2.76, P = 0.000), live birth rate (RR: 2.46; 95%CI: 1.57 to 3.85, P = 0.000), cycle cancellation rate (RR: 0.46, 95%CI: 0.23 to 0.93, P = 0.000), and embryo implantation rate (RR: 2.71; 95%CI: 1.91 to 3.84, P = 0.000). There were no statistically significance in spontaneous abortion rate (RR: 0.85, 95%CI: 0.40 to 1.78, P = 0.659), chemical pregnancy rate (RR: 1.84, 95%CI: 0.72 to 4.72, P = 0.204) and endometrial vascular improvement rate (RR: 1.10; 95%CI: 0.89 to 1.38, P = 0.367) between the two groups. The limitations of this study includes that, we only included single lauguage for literature research, the sample size and heterogeneity which could cause criteria bias.
CONCLUSIONS: Intrauterine PRP infusion may be an effective and safe treatment for women with thin endometrium. Further high-quality, large-sample, randomized controlled trials are needed to validate the reliability of our results.
BACKGROUND: The review protocol is registered on PROSPERO with registration number CRD42023490421, and no modifications were made to the information provided at registration.