Cover
Vol. 13 No. 2 (2023)

Published: November 30, 2023

Pages: 1-15

Research Article

Leukemia Inhibitory Factor as an Indicator for Determination of the Optimal Time of Intrauterine PRP Infusion in ICSI Cases.

Abstract

The compromise of uterine receptivity is one of the main reasons for the failure of assisted reproduction techniques. Leukemia inhibitory factor is one of those molecular parameters that allow us to identify an endometrium as receptive. Platelet rich plasma (PRP) contains a range of cytokines and growth factors including leukemia inhibitory factor that encourage the migration, proliferation, and differentiation of cells. Treatments for antagonist ovarian stimulation were administered to 75 women under the age of 40, and 2-D power doppler ultrasound was used to guide the oocyte harvest. Patients were allocated into three groups according to the time of intrauterine infusion of PRP (no PRP, PRP at triggering day and PRP at ova pickup day). Power Doppler is utilized to measure endometrial thickness (ET), pulsatility index (PI), and resistance index (RI) of sub endometrial arteries, as well as serum levels of leukemia inhibitory factor (LIF). The mean endometrial thickness as well as serum level of LIF in PRP trigger group were higher, resistance index and pulsatility index were lower in a significant manner than control and PRP ova pickup group at all the days of study (triggering, ova pickup and embryo transfer days). These findings revealed that intrauterine PRP infusion on ova pick up day is associated with a significant increase in serum level of LIF that in turn enhances endometrial thickness for patients scheduled for intracytoplasmic sperm injection (ICSI).

References

  1. Hernández-Valencia M, Valencia-Ortega J, Ríos-Castillo B, Cruz-Cruz PR, Vélez- Sánchez D. Elements of implantation and placentation, clinical and molecular aspects. Playback 2014; 7: 102-116.
  2. Makrigiannakis A, Minas V. Mechanisms of implantation. Reproductive BioMedicine Online 2007; 14 (1): 102-109.
  3. Devesa Rodríguez de la Rua M. Factors associated with implantation failure: embryonic factor in advanced maternal age. [Doctoral Thesis]. Barcelona: Autonomous University of Barcelona; 2015.
  4. Hoozemans, D.A., Schats, R., Lambalk, C.B., Homburg, R. and Hompes, P.G. (2004) Human embryo implantation: current knowledge and clinical implications in assisted reproductive technology. Reprod Biomed Online 9:692-715
  5. Krüger, J., Freymann, U., Vetterlein, S., Neumann, K., Endres, M. and Kaps C., 2013. Bioactive Factors in Platelet-Rich Plasma Obtained by Apheresis. Transfusion Medicine and Hemotherapy, 40 (6), pp.4-4.
  6. Dhillon, M.S., Patel, S. and John, R., 2017. PRP in OA knee–update, current confusions, and future options. Sicot-j, 3.
  7. Bos-Mikich, A., Ferreira, M.O., de Oliveira, R. and Frantz, N., 2019. Platelet-rich plasma or blood-derived products to improve endometrial receptivity? Journal of assisted reproduction and genetics, 36 (4), pp.613-620.
  8. Aghajanova, L., Houshdaran, S., Balayan, S., Manvelyan, E., Irwin, J.C., Huddleston, H.G. and Giudice, L.C., 2018. In vitro evidence that platelet-rich plasma stimulates cellular processes involved in endometrial regeneration. Journal of assisted reproduction and genetics, 35 (5), pp.757-770
  9. Lazzaroni-Tealdi, E., Barad, D.H., Albertini, D.F., Yu, Y., Kushnir, V.A., Russell, H., Wu, Y.G. and Gleicher, N., 2015. Oocyte scoring enhances embryo scoring in predicting pregnancy chances with IVF, where it counts most. PLoS One, 10 (12), p.e0143632.
  10. Tiitinen, A., 2019. Single embryo transfer: why and how to identify the embryo with the best developmental potential. Best Practice & Research Clinical Endocrinology & Metabolism, 33 (1), pp.77-88.
  11. Chang, Y., Li, J., Chen, Y., Wei, L., Yang, X., Shi, Y. and Liang, X., 2015. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization. International Journal of Clinical and Experimental Medicine, 8 (1), p.1286.
  12. Gupta, J., Jain, B. and Jain, K., 2020. Effect of autologous platelet-rich plasma on clinical outcome in patients with suboptimal endometrium in fresh ICSI/FET cycle− an interventional prospective study. Fertility Science and Research, 7 (1), p.70.
  13. Stewart J. Russell, Yat Sze Sheila Kwok, Tina Tu-Thu Ngoc Nguyen & Clifford Librach. Autologous platelet-rich plasma improves the endometrial thickness and live birth rate in patients with recurrent implantation failure and thin endometrium. Journal of Assisted Reproduction and Genetics. 39, pages1305–1312 ( 2022 )
  14. Zhao, J., Zhang, Q., Wang, Y. and Li, Y., 2014. Endometrial pattern, thickness, and growth in predicting pregnancy outcome following 3319 IVF cycle. Reproductive biomedicine online, 29 (3), pp.291-298.
  15. Motwani, Y. and Sharma, R.K., 2020. To study the effect of autologous platelet-rich plasma instillation on suboptimal endometrium and pregnancy outcomes in infertile women undergoing frozen embryo transfer cycle. Fertility Science and Research, 7 (2), p.141.
  16. Alzaidi, Z., Yildiz, Ş.M., Saatçi, Ç. et al. The effect of cytokine leukemia-inhibitory factor (LIF) and interleukin-11 (IL-11) gene expression on the primary infertility related to polycystic ovary syndrome, Tubal factor, and Unexplained infertility in Turkish women. Egypt J Med Hum Genet 22, 85 (2021). https://doi.org/10.1186/s43042-021-00201-9