Autologous platelet-rich plasma infusion does not improve pregnancy outcomes in frozen embryo transfer cycles in women with history of repeated implantation failure without thin endometrium.

AIM: The effect of intrauterine infusion of platelet-rich plasma (PRP) which has been shown to improve the pregnancy outcomes in patients suffering from repeated implantation failure (RIF), is intended to be studied in patients with normal endometrial thickness. METHODS: We recruited 85 patients with RIF and normal endometrial thickness (≥7 mm). After obtaining their consent, they were stratified into the intervention (PRP) and control groups, according to the patient's decision. Out of 85 participants, 42 received PRP, while 43 were included in the control group. In the PRP group, 1 mL of PRP was extracted from 10 cc of whole blood via two rounds of centrifugation and infused 2 days before the embryo transfer (ET). RESULTS: The pregnancy outcomes, including biochemical, clinical and ongoing pregnancy (≥20 weeks of gestation) rates were similar between the PRP (35.7, 31.0 and 26.8%, respectively) and control (37.2, 37.2 and 25.6%, respectively) groups. CONCLUSION: We concluded that PRP is not an effective adjuvant treatment for in vitro fertilization of patients with RIF and normal endometrial thickness undergoing ET.

The role of inhibin B in prediction of in vitro fertilization or intracytoplasmic sperm injection cycles' outcome.

OBJECTIVE: To investigate the usefulness of inhibin B concentrations obtained on the fifth day in predicting ovarian response and assisted reproductive technologies outcome. METHODS: In this prospective multi-center study, infertile women who were candidate for in vitro fertilization or intracytoplasmic sperm injection for the first time were enrolled. These patients were referred to the Royan Institute, Vali-Asr Hospital and Alvand Hospital, Tehran, Iran between 2003 and 2004. The inclusion criteria were female age (20-35 years), body mass index (BMI) of 20-28 Kg/m2, duration of infertility>2 years, a normal menstrual cycle and a normal day 3 follicle stimulating hormone level of <8.5 IU/l. All patients underwent long standard gonadotrophin releasing hormone agonist protocol. Plasma level of inhibin B was checked on the fifth day of menstrual cycle. The diagnostic accuracy of inhibin B, were assessed by the area under the receiver operating characteristic (ROC) curve. RESULTS: In this study, 107 infertile patients were studied. Using the value of 283 pg/ml for inhibin B as the cut-off point, day 5 inhibin B had 77% sensitivity, 30% specificity, 31.2% positive predictive values (PPV) and 76.7% negative predictive values (NPV) for poor ovarian response. There were statistically significant correlation among day 5 inhibin B concentration and BMI, number of mature follicles, retrieved oocytes, developed and transferred embryos, chemical pregnancy, ovarian hyperstimulation syndrome (OHSS) and poor responder. CONCLUSION: Although the chemical pregnancy, number of retrieved oocytes, developed and transferred embryos were higher in patients with higher day 5 inhibin B concentration but considering its sensitivity, specifity, PPV and NPV, it cannot be used as a strong test for prediction of cancellation, pregnancy, poor responses and OHSS.