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- Title
Treatment of refractory thin endometrium with autologous blood cell derivative (ABCD-Endosera): Advancing toward a next-generation of platelet-derived growth factors in frozen embryo transfer cycles: A pilot study.
- Authors
Murdia, Kshitiz; Chandra, Vipin; Bhoi, Nihar; Gupta, Shyam; Gupta, Nitasha; Mistari, Walmik; Chari, Shrinivas; Palanivel, Vasanthi
- Abstract
Study question: Can platelet derived growth factors be useful for refractory endometrium management Aims and Objectives: Tissue engineering traditionally stimulates cells using a single protein. For example use of G-CSF for endometrial regeneration. In contrast, natural tissue regeneration relies on cocktail of signalling molecules and growth factors. This study is to evaluate the regenerative effect of platelet derived growth factors (ABCD-Endosera) on refractory thin endometrium. Material and Methods: This was a retrospective self-controlled pilot study. Forty-one women who had two or more failed IVF cycles and refractory thin endometrium were enrolled in this study. The main inclusion criteria were endometrial thickness (EMT) of <7 mm after more than 2 cycles of conventional therapy. The subjects were treated with intrauterine infusion of autologous platelet-derived growth factors concentrate 3 times from menstrual cycle day 6 of their frozen-thawed embryo transfer (FET) cycle in addition to standard HRT protocols, and embryo transfer was performed 3 days after the final PDGF infusion. On the day of embryo transfer (ET) the endometrial thickness was found to be >7mm with a tri-laminar pattern in all the patients and subsequently ET was performed. Clinical pregnancy was determined by positive serum β-HCG, two weeks after ETand the presence of a fetal heartbeat in trans-vaginal ultrasound four weeks after ET. Results: Endometrial thickness showed significant improvement on the day of embryo transfer with a uniform triple-layer pattern. Clinical pregnancy was achieved in 17 out of the 41 women participating in the study, representing a 41.5% success rate, indicative of a potential enhancement in clinical pregnancy rates attributable to ABCD-Endosera treatment. The remaining 24 participants, constituting 58.5% of the sample, did not achieve clinical pregnancy. There were no reported instances of miscarriages, and each participant experienced a full-term delivery, underscoring the effectiveness of the treatment. Furthermore, while the sample size is small, still this study would become valuable and encourage proof of concept data to increase the research about this type of treatment. Summary & Conclusion: In conclusion, our pilot study offers initial evidence affirming the potential of ABCD-Endosera in addressing refractory thin endometrium. Utilizing this autologous concoction of platelet-derived growth factors has shown significant enhancement in endometrial thickness and receptivity, leading to encouraging pregnancy outcomes. Nevertheless, to reinforce these preliminary results and establish the optimum therapeutic protocol for ABCD-Endosera, comprehensive large-scale and rigorous studies are indispensable. The prospective benefits of ABCD-Endosera in ameliorating endometrial receptivity are crucial, especially considering the time-sensitive context of IVF procedures. This novel therapeutic strategy holds the promise of transforming the management of refractory thin endometrium, thereby increasing the probability of positive pregnancy outcomes for women facing infertility challenges.
- Subjects
INDIA; INFERTILITY treatment; PILOT projects; RESEARCH; ENDOMETRIAL diseases; AUTOTRANSFUSION of blood; GROWTH factors; BLOOD platelets; RETROSPECTIVE studies; ACQUISITION of data; EMBRYO transfer; TREATMENT effectiveness; MEDICAL records; DESCRIPTIVE statistics; FERTILIZATION in vitro; DATA analysis software; ENDOMETRIUM; EVALUATION
- Publication
Fertility Science & Research, 2023, Vol 10, Issue 3, p151
- ISSN
2394-4285
- Publication type
Article
- DOI
10.4103/fsr.fsr_28_23