Obesity Attenuates the Beneficial Effect of an Intrauterine Infusion of Autologous Platelet-rich Plasma During in Vitro Fertilization

Overview

Journal Am J Transl Res

Specialty General Medicine

Date 2024 Apr 8

PMID 38586113

Authors

Dinorah Hernandez-Melchor

Hector Carrillo

Alfredo Martin Rivera

Leonardo M Porchia

Priscila M Bartolo-Gomez

Jazmin Martinez

America Padilla-Viveros

Martha Elba Gonzalez-Mejia

Esther Lopez-Bayghen

Affiliations

Soon will be listed here.

Abstract

Objective: To assess how obesity, normal weight (NW) versus overweight/obese (OW/OB), impacts platelet-rich plasma's (PRP) effectiveness during fertilization and how obesity affects platelets during the menstrual cycle.

Methods: Endometrial mean thickness (EMT), embryo implantation, and clinical pregnancy were assessed using a self-controlled retrospective study that enrolled 59 patients with two failed cycles and treated with autologous PRP (three-dose scheme). The NHANES dataset was used to assess platelet changes during the menstrual cycle, using the mean platelet volume to platelet count ratio (MPR) index. The COSINOR packages for R were used to determine rhythmicity.

Results: PRP treatments significantly improved the EMT (2.5 ± 1.4 mm, P<0.001), unaffected by obesity. After the PRP treatment, one patient spontaneously became pregnant; therefore, 58 patients underwent embryo transfer (62 cycles), of which in 39 cycles the embryos implanted (63.9%). This was a significant improvement from their previous cycle (vs. 22.6%, P<0.001). Clinical pregnancy also improved with the PRP treatment over the previous cycle (57.4% vs. 16.1%, P<0.001). When stratified by obesity, there was an appreciable decrease in embryo implantation and clinical pregnancy rates for the OW/OB group; nevertheless, the PRP treatment significantly improved embryo implantation and clinical pregnancy (P<0.05). A rhythm was observed with the MPR index (P<0.05) only for the NW group, suggesting that the platelets normally fluctuate during the menstrual cycle.

Conclusion: PRP improved embryo implantation and clinical pregnancy rates; however, these beneficial effects were attenuated by obesity. PRP presumptively promoted a change in the uterine environment to mimic the normal findings associated with normal-weight women.

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