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Hysteroscopic Injections of Autologous Endometrial Cells and Platelet-rich Plasma in Patients With Thin Endometrium

Phase 1
Completed
Conditions
Thin Endometrium
Registration Number
NCT05455151
Lead Sponsor
Federal State Budget Institution Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare
Brief Summary

The investigation is devoted to the study of the effect of the introduction of autologous platelet-rich plasma (PRP) on the thickness of the endometrium. It was found that the injection of PRP and endometrial cells resuspended in PRP into the endometrium of patients with thin endometrium leads to an increase in the proliferation of endometrial cells, and as a result, to an increase in its thickness.

Detailed Description

The study enrolled 115 patients with thin endometrium (\<7 mm at implantation window) and infertility. The cohort was divided into groups based on the treatment regimen.

Group 1 (the control, n=30) underwent conservative therapy. Group 2 (n=42) received intraendometrial injections of autologous PRP instead of the conservative therapy. Group 3 (n=38) received identical injections after conservative therapy. Group 4 (n=5) received injections of the minimally manipulated autologous endometrial cells suspended in autologous PRP.

Injections of PRP and endometrial cells suspended in autologous PRP into basal layer of endometrium facilitate the reconstitution by enhancing cell proliferation and angiogenesis.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
115
Inclusion Criteria
  • Age 18-40 years
  • Normal karyotype
  • Normal karyotype of the partner
  • Regular ovulatory and menstrual cycle
  • Endometrium <7 mm thick as measured at implantation window
  • Availability of ≥2 vitrified blastocysts of good quality
  • History of implantation failure and/or embryo transfer (ET) cancellation due to insufficient endometrial thickness
Exclusion Criteria
  • Pathospermia in partner
  • Use of donor gametes
  • Premature ovarian failure
  • Internal genital anomalies
  • Systemic blood diseases and coagulopathy
  • Hemoglobin <100 g/L
  • Platelets <100×109/L
  • Antiplatelet/anticoagulant therapy recipient status

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Study of the effect of therapy on the onset of pregnancy9 months

Investigation of the rates of clinical pregnancies and live births in all groups. After therapy, the number of clinical pregnancy and the number of live births were calculated.

Change in endometrial thickness after treatment compared with control.Baseline and 2 month

Ultrasonography measurements of endometrial thickness before and after the therapy and compare the thickness. Endometrial thickness measured in mm.

The Doppler-assisted detection of the uterine spiral arteries1 month

The number of identified vessels is counted and the percentage of detection frequency is calculated accordingly, adjusted for the McNemar's binomial test. Compare the rates of visualization of the uterine spiral arteries after therapy in all groups of patients.

The content of growth factor in autologous PRP3 month

Investigation of the content of platelet-derived growth factor-BB (PDGF-BB) and vascular endothelial growth factor (VEGF) in autologous PRP. Relative levels of PDGF-BB and VEGF are normalized to the total protein content.

Phenotyping of cells isolated from endometrial biopsies3 month

Investigation of cellular composition in endometrial biopsy. The percentage of cells positive for markers of mesenzymal stromal cells, epithelial and endothelial cells, lymphocytes is calculated and the determination of the phenotype of cells in endometrial biopsy.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Federal State Budget Institution Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare

🇷🇺

Moscow, Russian Federation

Federal State Budget Institution Research Center for Obstetrics, Gynecology and Perinatology Ministry of Healthcare
🇷🇺Moscow, Russian Federation

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