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. 2023 Jun 1;20(2):154-163.
doi: 10.4274/tjod.galenos.2023.46588.

How autologous platelet-rich plasma affects pregnancy and birth outcomes in women with repeated embryo implantation failure: A prisma-compliant meta-analysis

Ahmed Soliman  1   2   3 , Saif Elsonbaty  1   2   3 , Yehia Saleh  1   2   3 , Dana Hegazy  1   2   3 , Hazem Metwally Faragallah  2   4
Affiliations

How autologous platelet-rich plasma affects pregnancy and birth outcomes in women with repeated embryo implantation failure: A prisma-compliant meta-analysis

Ahmed Soliman et al. Turk J Obstet Gynecol. .

Abstract

Repeated implantation failure refer to failure to conceive after three or more embryo transfer attempts. Several interventions were offered to improve maternal and fetal outcomes. Our objective was to investigate the impact of platelet-rich plasma (PRP) as a promising intervention to improve both pregnancy and birth outcomes. We searched PubMed, Scopus, Web of Science, and Cochrane Central, in addition to other relevant resources of grey literature. Only clinical trials were eligible to be included. We performed the meta-analysis using a random effects model. Eight randomized clinical trials, enrolling 1038 women with more than 3 implantation failure attempts, were included. We found a significant increase regarding all our prespecified primary outcomes. Chemical pregnancy rate [relative ratio (RR): 1.96, 95% confidence interval (CI): 1.61, 2.39; p<0.001], clinical pregnancy rate (RR: 4.35, 95% CI: 1.92, 2.88; p<0.001), and live birth rate (RR: 4.03, 95% CI: 1.29, 12.63; p=0.02) were found to be statistically significant and increased in patients who received PRP compared with the control group. Implantation rate (RR: 1.98, 95% CI: 1.34, 2.75; p<0.001), miscarriage rate (RR: 0.44, 95% CI: 0.23, 0.83, p=0.01), and multiple pregnancy rate (RR: 2.56, 95% CI: 1.02, 6.42, p=0.04) were also found to be significantly increased in the PRP group. We provide strong evidence on how intrauterine PRP can improve implantation, pregnancy, and birth outcomes in RIF women, which should direct clinicians to consider this intervention as a very effective tool in assisted reproductive techniques.

Keywords: Platelet-rich plasma; assisted reproductive techniques and in vitro fertilization; implantation failure.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram
Figure 2
Figure 2
Risk of bias (ROB) summary and graph
Figure 3
Figure 3
Meta-analysis of live birth rate (LBR) per patient
Figure 4
Figure 4
Meta-analysis of Chemical pregnancy rate per patient
Figure 5
Figure 5
Meta-analysis of Clinical Pregnancy Rate (CPR) per patient
Figure 6
Figure 6
Meta-analysis of Implantation Rate (IR) per embryo
Figure 7
Figure 7
Meta-analysis of Multiple Pregnancy Rate (MPR) per patient
Figure 8
Figure 8
Meta-analysis of Miscarriage Rate (MR) per clinical pregnancy
Figure 9
Figure 9
Meta-analysis of Post-interventional endometrial thickness (PIET), subgrouped according to the period from PRP infusion to time to measure the endometrial thickness
See this image and copyright information in PMC

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