自体富血小板浓缩物在女性生育力重塑中的应用进展

doi:10.3969/j.issn.1006-7795.2025.04.009

摘要/Abstract

摘要： 女性不孕症被世界卫生组织视为全球公共卫生问题，女性生育力重塑包括卵巢功能重建、子宫/子宫内膜重建等。自体富血小板浓缩物制备简单、自体应用更安全、更易接受，在再生医学中扮演重要角色，正成为一项新兴的热点技术，目前广泛应用于颌面和整形外科、皮肤病学等领域中。本文主要综述自体富血小板浓缩物在女性生育力重塑中的应用进展。

关键词: 自体富血小板浓缩物, 女性生育力重塑, 宫腔粘连, 薄型子宫内膜, 早发性卵巢功能不全, 卵巢组织冻存移植

Abstract: Female infertility is recognized as a global public health issue by the World Health Organization. Female fertility remodeling includes ovarian function reconstruction and uterus/endometrium reconstruction, etc. It is emerging as a hot technology since it is ready to prepare autologous platelet-rich concentrate and it is safer and more acceptable in autologous application. It plays an important role in regenerative medicine, and it is currently widely applied in maxillofacial and plastic surgery, dermatology and other clinical practices. This article mainly reviews the progresses of the application of autologous platelet-rich concentrate in female fertility remodeling.

Key words: autologous platelet-rich concentrate, female fertility remodeling, uterine adhesion, thin endometrium, premature ovarian insufficiency, cryopreserved ovarian tissue transplantation

中图分类号:

程姣姣, 阮祥燕, 杜娟, 金凤羽, 谷牧青, 李扬璐. 自体富血小板浓缩物在女性生育力重塑中的应用进展[J]. 首都医科大学学报, doi: 10.3969/j.issn.1006-7795.2025.04.009.

Cheng Jiaojiao, Ruan Xiangyan, Du Juan, Jin Fengyu, Gu Muqing, Li Yanglu. Progresses in the application of autologous platelet-rich concentrate in female fertility remodeling[J]. Journal of Capital Medical University, doi: 10.3969/j.issn.1006-7795.2025.04.009.

参考文献

［1］GBD 2021 Fertility and Forecasting Collaborators. Global fertility in 204 countries and territories,1950－2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021［J］. Lancet, 2024, 403(10440): 2057－2099.
［2］Cox C M, Thoma M E, Tchangalova N, et al. Infertility prevalence and the methods of estimation from 1990 to 2021: a systematic review and meta-analysis［J］. Hum Reprod Open, 2022, 2022(4): hoac051.
［3］Rughetti A, Giusti I, D'Ascenzo S, et al. Platelet gel-released supernatant modulates the angiogenic capability of human endothelial cells［J］. Blood Transfus, 2008, 6(1): 12－17.
［4］Alves R, Grimalt R. A review of Platelet-Rich plasma: history, biology, mechanism of action, and classification［J］. Skin Appendage Disord, 2018, 4(1): 18－24.
［5］Urman B, Boza A, Balaban B. Platelet-rich plasma another add-on treatment getting out of hand? How can clinicians preserve the best interest of their patients?［J］. Hum Reprod, 2019, 34(11): 2099－2103.
［6］Dohan Ehrenfest D M, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte-and platelet-rich fibrin(L-PRF)［J］. Trends Biotechnol, 2009, 27(3): 158－167.
［7］Vali S, Saso S, Bracewell Milnes T, et al. The clinical application of platelet-rich plasma in the female reproductive system: a narrative review［J］. Life, 2023, 13(12): 2348.
［8］Subiran Adrados C, Cadenas J, Zheng M X, et al. Human platelet lysate improves the growth and survival of cultured human pre-antral follicles［J］. Reprod Biomed Online, 2023, 47(5): 103256.
［9］Miron R J, Gruber R, Farshidfar N, et al. Ten years of injectable platelet-rich fibrin［J］. Periodontol 2000, 2024, 94(1): 92－113.
［10］中国输血协会临床输血管理学专业委员会. 自体富血小板血浆制备技术专家共识［J］. 中国输血杂志, 2021, 34(7): 677－683.
［11］Rodriguez-Eguren A, Bueno-Fernandez C, Gomez-Alvarez M, et al. Evolution of biotechnological advances and regenerative therapies for endometrial disorders: a systematic review［J］. Hum Reprod Update, 2024, 30(5): 584－613.
［12］Mouanness M, Ali-Bynom S, Jackman J, et al. Use of intra-uterine injection of platelet-rich plasma (PRP) for endometrial receptivity and thickness: a literature review of the mechanisms of action［J］. Reprod Sci, 2021, 28(6): 1659－1670.
［13］ESHRE Add-ons working group, Lundin K, Bentzen J G, et al. Good practice recommendations on add-ons in reproductive medicine［J］. Hum Reprod, 2023, 38(11): 2062－2104.
［14］Kim J H, Park M, Paek J Y, et al. Intrauterine infusion of human platelet-rich plasma improves endometrial regeneration and pregnancy outcomes in a murine model of Asherman's syndrome［J］. Front Physiol, 2020, 11: 105.
［15］Wang G F, Zhu Y J, Duan N, et al. Does platelet-rich plasma improve adhesion recurrence and pregnancy outcomes in women with intrauterine adhesions? A systematic review and meta-analysis［J］. J Minim Invasive Gynecol, 2025, 32(2): 133－142, e7.
［16］中国人体健康科技促进会妇科内分泌和生育力促进分会, 中国女医师协会输血专业委员会. 自体富血小板纤维蛋白(PRF)治疗宫腔粘连专家共识［J］. 临床输血与检验,2022,24(3):279－284.
［17］Serdarogullari M, Raad G, Makieva S, et al. Revitalizing female fertility: platelet-rich plasma-hype or hope?［J］. Reprod Biomed Online, 2024, 49(2): 103813.
［18］Sfakianoudis K, Simopoulou M, Nitsos N, et al. Successful implantation and live birth following autologous platelet-rich plasma treatment for a patient with recurrent implantation failure and chronic endometritis［J］. In Vivo, 2019, 33(2): 515－521.
［19］Marini M G, Perrini C, Esposti P, et al. Effects of platelet-rich plasma in a model of bovine endometrial inflammation in vitro［J］. Reprod Biol Endocrinol, 2016, 14(1): 58.
［20］Du J, Lu H, Yu X J, et al. Efficacy and safety of platelet-rich plasma for the treatment of thin endometrium: a protocol for systematic review and meta-analysis［J］. Medicine, 2020, 99(3): e18848.
［21］Agarwal M, Mettler L, Jain S, et al. Management of a thin endometrium by hysteroscopic instillation of platelet-rich plasma into the endomyometrial junction: a pilot study［J］. J Clin Med, 2020, 9(9): 2795.
［22］Dix E, Check J H. Successful pregnancies following embryo transfer despite very thin late proliferative endometrium［J］. Clin Exp Obstet Gynecol, 2010, 37(1): 15－16.
［23］Kasius A, Smit J G, Torrance H L, et al. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis［J］. Hum Reprod Update, 2014, 20(4): 530－541.
［24］Alfer J, Happel L, Dittrich R, et al. Insufficient angiogenesis: cause of abnormally thin endometrium in subfertile patients?［J］. Geburtshilfe Frauenheilkd, 2017, 77(7): 756－764.
［25］Chang Y J, Li J J, Chen Y Q, et al. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcome during in vitro fertilization［J］. Int J Clin Exp Med, 2015, 8(1): 1286－1290.
［26］Chang Y J, Li J J, Wei L N, et al. Autologous platelet-rich plasma infusion improves clinical pregnancy rate in frozen embryo transfer cycles for women with thin endometrium［J］. Medicine, 2019, 98(3): e14062.
［27］Chang Y J, Peng J T, Zhu Y Y, et al. How platelet-rich plasma (PRP) intra-uterine injection improve endometrial receptivity of intrauterine adhesions in women: a time-series-based self-controlled study［J］. J Reprod Immunol, 2023, 156: 103796.
［28］Franasiak J M, Alecsandru D, Forman E J, et al. A review of the pathophysiology of recurrent implantation failure［J］. Fertil Steril, 2021, 116(6): 1436－1448.
［29］Duffy J M N, Adamson G D, Benson E, et al. Top 10 priorities for future infertility research: an international consensus development study［J］. Fertil Steril, 2021, 115(1): 180－190.
［30］ESHRE Working Group on Recurrent Implantation Failure, Cimadomo D, de Los Santos M J, et al. ESHRE good practice recommendations on recurrent implantation failure［J］. Hum Reprod Open, 2023, 2023(3): hoad023.
［31］Yahyaei A, Madani T, Vesali S, et al. Intrauterine infusion of autologous platelet rich plasma can be an efficient treatment for patients with unexplained recurrent implantation failure［J］. Sci Rep, 2024, 14(1): 26009.
［32］Atkinson L, Martin F, Sturmey R G. Intraovarian injection of platelet-rich plasma in assisted reproduction: too much too soon?［J］. Hum Reprod, 2021, 36(7): 1737－1750.
［33］Fraidakis M, Giannakakis G, Anifantaki A, et al. Intraovarian platelet-rich plasma injections: safety and thoughts on efficacy based on a single centre experience with 469 women［J］. Cureus, 2023, 15(5): e38674.
［34］Panda S R, Sachan S, Hota S. A systematic review evaluating the efficacy of intra-ovarian infusion of autologous platelet-rich plasma in patients with poor ovarian reserve or ovarian insufficiency［J］. Cureus, 2020, 12(12): e12037.
［35］Cakiroglu Y, Saltik A, Yuceturk A, et al. Effects of intraovarian injection of autologous platelet rich plasma on ovarian reserve and IVF outcome parameters in women with primary ovarian insufficiency［J］. Aging, 2020, 12(11): 10211－10222.
［36］Herlihy N S, Cakiroglu Y, Whitehead C, et al. Effect of intraovarian platelet-rich plasma injection on IVF outcomes in women with poor ovarian response: the PROVA randomized controlled trial［J］. Hum Reprod, 2024, 39(7): 1495－1503.
［37］Cakiroglu Y, Yuceturk A, Karaosmanoglu O, et al. Ovarian reserve parameters and IVF outcomes in 510 women with poor ovarian response (POR) treated with intraovarian injection of autologous platelet rich plasma (PRP)［J］. Aging, 2022, 14(6): 2513－2523.
［38］Ruan X Y, Xu C, Huang H F, et al. Practice guideline on ovarian tissue cryopreservation and transplantation in the prevention and treatment of iatrogenic premature ovarian insufficiency［J］. Maturitas, 2024, 182: 107922.
［39］国际妇科内分泌学会中国妇科内分泌学分会及共识专家. 卵巢组织冻存与移植中国专家共识［J］. 中国临床医生杂志, 2018, 46(4): 496－500.
［40］中国人体健康科技促进会生育力保护与保存专业委员会, 国际妇科内分泌学会中国妇科内分泌学分会, 北京妇产学会内分泌分会,等. 卵巢组织冻存移植防治医源性早发性卵巢功能不全临床应用指南［J］. 首都医科大学学报,2023,44(5):695－703.
［41］Ruan X, Du J, Lu D, et al. First live birth in China after cryopreserved ovarian tissue transplantation to prevent premature ovarian insufficiency［J］. Climacteric, 2022, 25(4): 421－424.
［42］阮祥燕, 杜娟, 金凤羽, 等. 中国卵巢组织冻存与移植后自然妊娠第2例报道［J］. 中国医刊, 2024, 59(5): 567－570.
［43］Lee J, Kong H S, Kim E J, et al. Ovarian injury during cryopreservation and transplantation in mice: a comparative study between cryoinjury and ischemic injury［J］. Hum Reprod, 2016, 31(8): 1827－1837.
［44］Cheng J J, Ruan X Y, Li Y L, et al. Effects of hypoxia-preconditioned HucMSCs on neovascularization and follicle survival in frozen/thawed human ovarian cortex transplanted to immunodeficient mice［J］. Stem Cell Res Ther, 2022, 13(1): 474.
［45］Callejo J, Salvador C, González-Nuñez S, et al. Live birth in a woman without ovaries after autograft of frozen-thawed ovarian tissue combined with growth factors［J］. J Ovarian Res, 2013, 6(1): 33.
［46］Subiran Adrados C, Olesen H Ø, Olesen S V, et al. Exploring the effect of platelet-rich plasma on vascularization and survival of follicles in xenotransplanted human ovarian tissue［J］. Reprod Biomed Online, 2024, 49(4): 104274.
［47］Chung N, Yang C, Yang H, et al. Local delivery of platelet-derived factors mitigates ischemia and preserves ovarian function through angiogenic modulation: a personalized regenerative strategy for fertility preservation［J］. Biomaterials, 2025, 313: 122768.
［48］Hosseini L, Shirazi A, Naderi M M, et al. Platelet-rich plasma promotes the development of isolated human primordial and primary follicles to the preantral stage［J］. Reprod Biomed Online, 2017, 35(4): 343－350.
［49］Vaidakis D, Papapanou M, Siristatidis C S. Autologous platelet-rich plasma for assisted reproduction［J］. Cochrane Database Syst Rev, 2024, 4(4): CD013875.

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