39th Hybrid Annual Meeting of the ESHRE, Copenhagen – Denmark, 25-28 June 2023 i559

.. 3
Gunjan IVF World, Embryology, Ghaziabad, India
..
.. Study question: Does the subendometrial injection of autologous platelet-
..
.. rich plasma (PRP) guided by hysteroscopy achieve successful pregnancy out-
.. come in recurrent implantation failure patients?
.. Summary answer: In this study we observed that subendometrial injection
..
.. of autologous PRP is associated with higher implantation rates in recurrent
.. implantation failure patients.
.. What is known already: The key success factors in IVF are to have a good
.. endometrium lining and vascularity for successful implantation. These two fac-
..
.. tors directly affect the pregnancy outcomes of IVF.

Downloaded from https://academic.oup.com/humrep/article/38/Supplement_1/dead093.1100/7202841 by guest on 11 February 2024

.. Although several approaches have been attempted to address these factors
.. including estrogen treatment, aspirin, sildenafil, vitamin E, Granulocyte-Colony
..
.. Stimulating Factor (G-CSF), there is no efficient method described.
.. Additionally, some cases do not show a response to the medical treatment.
.. In those cases, specifically, in previously failed IVF patients autologous Platelet
.. Rich Plasma (PRP) injection into the sub-endometrial cavity with an ovum
..
.. pick up needle has been preferred, as confirmed by literature.
.. Study design, size, duration: An open label, single center study. Total 130
.. women were selected for hysteroscopic instillation of PRP, all patients have
..
.. previous unsuccessful IVF attempts in our clinic or were referred to our clinic.
.. Study participants are of age 23 to 49 years. Study began in July 2020 and
.. was completed in December 2022.
.. Participants/materials, setting, methods: 2 ml of autologous PRP was
..
.. instilled in the junctional zone using a wallace needle through the hystero-
.. scope’s operating channel to inject the PRP beneath the superficial endome-
.. trium from day 6-14 of menstrual cycle. FET preparation was started from
..
.. Day 2/3 of next menstrual cycle using 6 mg/daily estradiol hemihydrate (EV
.. Active Tab CORONA Remedies).
.. Main results and the role of chance: Women who received hysteroscopic
.. instillation of PRP in the sub-endometrial junction had higher pregnancy rates (82/
..
.. 130 [63.07%] (P-value ¼ <0.05). In the subsequent cycle monitored to day 15,
.. Endometrial thickness (ET) was 7 mm or thicker in 90 of 130 patients [69.23%]
.. (P-value ¼ <0.05) and 6-7 mm in 8 of 130 patients [6.15%]. Endometrial thickness
..
.. did not improve in 32 of 130 patients [24.61%] and remained below 6 mm.
.. Subendometrial blood flow increased significantly in 92 of 130 patients [70.76%]
.. (P-value ¼ <0.05). The mean increase in ET was 1.5 to 2 mm.
.. The instillation of PRP caused no side effects and was well tolerated by all
..
.. patients. In 47 patients (36.15%) we did not achieve clinical pregnancy while 1
.. had a biochemical pregnancy
.. Based on paired ‘t’ test, it is concluded that there is statistically significant
.. improvement in ET, vascularity and successful pregnancy outcome after PRP
..
.. instillation.
.. Limitations, reasons for caution: Little is known about the best dosage
.. and time for the instillation of PRP in endometrium. The importance of stan-
..
.. dard yet simple techniques and a highly repeatable protocol for clinical use is
.. deciding factor which yet to finalize. It involves invasive procedure so may
.. cause infections and anesthesia related complications.
..
.. Wider implications of the findings: Although PRP has still not gained uni-
.. versal acceptance in previously failed IVF patients for a variety of reasons,
.. emerging evidences suggests that PRP could be an effective option compared
.. to conventional approach especially, in patients with thin endometrium, ad-
..
.. vanced maternal age and primary ovarian insufficiency.
.. Trial registration number: Not applicable
..
..
..
..
..
..
..
..
Abstract citation ID: dead093.1100 ..
P-792 The effect of subendometrial injection of autologous ..
platelet rich plasma (PRP) guided by hysteroscopy in recurrent ..
implantation failure patients - A pilot study
..
..
G. Gupta1, G. Sharma2, A. Raheja1, P. Sarkar3
..
..
1
..
Gunjan IVF world, Obstetrics and gynecology, Ghaziabad, India ..
2
Gunjan IVF World, Obstetrics and gynecology, New Delhi, India .
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