Intrauterine Perfusion Combined with Ovarian Injection of PRP for Improving Pregnancy Outcomes in Infertile Women with EMT.

چکیده اصلی

BACKGROUND: Endometriosis (EMT) is a major cause of infertility. Laparoscopic surgery is the standard treatment but carries a risk of recurrence and has limited effectiveness in improving pregnancy outcomes. Platelet-rich plasma (PRP) has been shown to promote endometrial repair and improve ovarian function, yet few studies have explored its combined application with surgery. METHODS: A total of 60 infertile patients with EMT were allocated into three groups according to their treatment plan: Group A (n = 20) received laparoscopic surgery only; Group B (n = 20) received surgery combined with in-trauterine PRP perfusion; Group C (n = 20) received surgery along with both intrauterine PRP perfusion and PRP injection into the affected ovary. Clinical efficacy, endometrial thickness and morphology, serum markers of ovarian function (luteinizing hormone [LH], follicle-stimulating hormone [FSH], estradiol [E2], anti-Müllerian hormone [AMH]), and pregnancy outcomes were compared among the three groups. RESULTS: The total clinical effective rate in Group C (95%) was significantly higher than that in Group A (60%). Postoperative endometrial thickness and the proportion of linear endometrium were higher in Groups B and C than in Group A, with the most significant improvement observed in Group C. Regarding ovarian function, postoperative FSH and LH levels in Group C were significantly lower than those in Groups A and B, while E2 and AMH levels were significantly higher. The clinical pregnancy rate, natural pregnancy success rate, and live birth rate in Group C were significantly higher than those in Group A. There were no significant differences in the incidence of pregnancy complications among the three groups. CONCLUSIONS: Laparoscopic surgery combined with intrauterine PRP perfusion and ovarian injection can effectively improve endometrial receptivity and ovarian reserve function in infertile patients with EMT, significantly increasing clinical pregnancy and live birth rates without increasing the risk of pregnancy complications. This combination represents a safe and effective adjuvant treatment strategy.

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