en بررسی تأثیر اضافه کردن پلاسمای غنی از پلاکت اتولوگ به محیط کشت انتقال جنین برای میزان موفقیت: یک مطالعه RCT Fertility & Infertility Original Article Original Article <div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در سال‌های اخیر مطالعات متعددی اثر مفید پلاسمای غنی از پلاکت (</span></span><span dir="LTR" style="font-size:10.0pt">PRP</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) را در بهبود عملکرد آندومتر در بیماران مبتلا به شکست مکرر لانه&shy;گزینی و اندومتر نازک نشان داده‌اند. هرچند که مکانیسم این اثر به&shy;خوبی مشخص نشده است.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">هدف از این مطالعه بررسی تأثیر مستقیم </span></span><span dir="LTR" style="font-size:10.0pt">PRP</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">بر فرآیند لانه&shy;گزینی در حین انتقال جنین در بیمارانی بدون سابقه آشکار نقایص لانه&shy;گزینی می&shy;باشد.</span></span><b><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial",sans-serif"></span></span></b></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">مواد و روش &shy;ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در این مطالعه کارآزمایی بالینی تصادفی، 55 زن نابارور (40-20 ساله) که کاندیدای تزریق داخل سیتوپلاسمی اسپرم بودند و به مرکز ناباروری بیمارستان فاطمیه همدان مراجعه کرده بودند انتخاب و به طور تصادفی در دو گروه مداخله و کنترل قرار گرفتند. در گروه مداخله، </span></span><span dir="LTR" style="font-size:10.0pt">PRP</span> <span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">به محیط کشت انتقال جنین اضافه شد و در گروه کنترل از محیط کشت انتقال جنین معمولی استفاده گردید. پس از انتقال جنین، حاملگی بیوشیمیایی و بالینی بررسی شد.</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">در گروه مداخله و کنترل 14 روز پس از انتقال، بتا گنادوتروپین جفتی انسانی مثبت به ترتیب 3/33% و 3/39% بود (646/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">). 21 روز پس از انتقال، ساک حاملگی در 3/33% در گروه مورد و 7/35% در گروه کنترل مشاهده شد (646/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">) و 28 روز پس از انتقال نیز قلب جنین به ترتیب در 3/33% و 7/35% از موارد دیده شد (631/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">).</span></span></span></span></span></span></span><br> <b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">نتیجه&shy; گیری:</span></span></b><span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:"> افزودن </span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">PRP</span></span> <span dir="RTL" lang="FA" style="font-size:11.0pt"><span b="" mitra="" style="font-family:">اتولوگ به محیط کشت در زمان انتقال جنین تأثیر مثبت مستقیمی بر لانه&shy;گزینی جنین ندارد و مشاهده اثرات مثبت در مطالعات قبلی احتمالا بطور غیرمستقیم ناشی از اثر بر روی ریزمحیط رحم باشد که نیاز به زمان دارد.</span></span></div> <div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Background:</span></span></b> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Several recent studies have shown the beneficial effect of </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">platelet-rich plasma (PRP) </span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">in improving endometrial function in cases with repeated implantation failure and thin endometrium. However, the mechanism of this effect is unclear.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Objective:</span></span></b> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">To investigate the direct effect of PRP on the implantation process during embryo transfer (ET) in cases without an obvious history of abnormality on implantation.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Materials and Methods:</span></span></b> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">In this randomized clinical trial study, 55 infertile women (20-40 yr) who were candidates for intracytoplasmic sperm injection referred to the Infertility Center of Fatemiyeh hospital in Hamadan, Iran</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times=""> between September 2022 and 2023</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">were randomly divided into intervention and control groups. In the intervention group, PRP was added to the ET medium, while in the control group, a routine ET medium was used</span></span><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">.</span></span> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">After ET, chemical and clinical pregnancy were measured. </span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="unicode-bidi:embed"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">Results:</span></span></b> <span style="font-size:12.0pt"><span new="" roman="" style="font-family:" times="">In the intervention and control groups beta human chorionic gonadotropin positivity 14 days after transfer was 33.3% and 39.3%, consecutively (p = 0.646). At 21 day post-transfer, gestational sac was observed in 33.3% and 35.7% of cases (p = 0.646). By 28 days after transfer fetal heart activity was detected in 33.3% and 35.7% of cases (p = 0.631).</span></span></span></span></span></span><br> <b><span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">Conclusion:</span></span></span></b> <span style="font-size:12.0pt"><span style="line-height:107%"><span new="" roman="" style="font-family:" times="">The addition of autologous PRP at the time of ET does not have a direct positive effect on embryo implantation, and the observation of positive effects in previous studies may be indirectly on the uterine microenvironment, which requires time.</span></span></span></div> لانه‌گزینی جنین, پلاسمای غنی از پلاکت, انتقال جنین. Embryo implantation, Platelet-rich plasma, Embryo transfer. 333 342 http://ijrm.ir/browse.php?a_code=A-10-1479-2&slc_lang=en&sid=1 Marzie Sanuie Farimani dr_farimani@yahoo.com 0000-0002-8953-3270 No Fertility and Infertility Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. Ashraf Aleyasin aleyasina@tums.ac.ir 0000-0002-4387-9102 No Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ashraf Moini ashraf.moieni@gmail.com 0000-0002-5074-2286 No Department of Infertility, Arash Hospital, Tehran University of Medical Sciences, Tehran, Iran. Iraj Amiri amiri44@yahoo.com 0000-0003-4587-736x No Fertility and Infertility Research Center, Hamadan University of Medical Sciences, Hamadan, Iran. Jalal Poorolajal poorolajal@yahoo.com 0000-0002-3758-3006 No Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran. Fahime Salari Shahrbabaki salari62f@gmail.com 0000-0003-3759-6170 Yes Fertility and Infertility Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.