Effect of intrauterine infusion of platelet-rich plasma for women with recurrent implantation failure: a systematic review and meta-analysis

Figures & data

Table 1. Characteristics of the included studies.

Study	Year	Study type	Region	Age	Interventions		Sample size (n)	Dose	Concentration	Embryonic stage	Embryo quality	Outcomes
					Case	Control
Coksuer, H.	2019	Cohort	Turkey	21–39	PRP	Standard treatment	70 (34/36)	1mL	The mean number of platelets in PRP was 992.45 ± 212.85 ± 103 cell/mL	Blastocyst	Patients with poor embryo quality were excluded from the study	Clinical pregnancy rate Live birth rate
Liu, P	2020	Cohort	China	<40	PRP	HRT	127 (63/64）	1mL	∼	Cleavage	The two to three embryos with the highest scores were transferred	Clinical pregnancy rate Implantation rate
Liu, P.	2021	RCT	China	<40	PRP	HRT	127 (63/64)	1mL	Platelets 4 − 5 times more than peripheral blood	∼	At least one embryo transferred should be of good quality	Clinical pregnancy rate Chemical pregnancy rate Implantation rate
Nazari, L.	2020	RCT	Iran	<40	PRP	Standard treatment	97 (49/48)	0.5 mL	Platelets 4 − 5 times more than peripheral blood	Blastocyst	Good quality blastocysts	Clinical pregnancy rate Chemical pregnancy rate
Nazari, L.	2022	RCT	Iran	18–38	PRP	Standard treatment	393 (196/197)	0.5 mL	Platelets 4 − 5 times more than peripheral blood	Blastocyst	Expansion grades 2 − 3 and ICM and TE with AA classifications	Clinical pregnancy rate Chemical pregnancy rate Live birth rate Abortion rate
Rageh, K. A. I.	2020	RCT	Egypt	< 40	PRP	Standard treatment	150 (75/75)	0.5–1mL	Platelets 4 − 5 times more than peripheral blood	Blastocyst	Grade A or B according to embryologic scoring	Chemical pregnancy rate
Safdarian, L.	2022	RCT	Iran	20–40	RPR	HRT	120 (60/60)	0.5mL	Platelets 4 − 5 times more than peripheral blood and 2000 lymphocyte/µL	Blastocyst	Good-quality Grade A or B	Clinical pregnancy rate Chemical pregnancy rate Live birth rate Implantation rate Abortion rate
Tehraninejad, E. S.	2021	Cohort	Iran	<35	PRP	HRT	85 (42/43)	1mL	Platelets 4 − 5 times more than peripheral blood	Blastocyst	At least two good to moderate quality blastocysts were transferred	Clinical pregnancy rate Chemical pregnancy rate
Xu, Y.	2022	Cohort	China	23–40	PRP	HRT or NC	288 (138/150)	1mL	Platelets in PRP was 1513.45 ± 322.18 × 109/L)	∼	One or two good quality embryos	Clinical pregnancy rate Chemical pregnancy rate Live birth rate Implantation rate Abortion rate
Zamaniyan, M.	2020	RCT	Iran	20–40	PRP	HRT	98 (55/43）	0.5mL	Platelets 4 – 7 times more than peripheral blood	Blastocyst	One or two good quality blastocysts (Grade A or B according to embryologic scoring)	Clinical pregnancy rate Chemical pregnancy rate Abortion rate

HRT: hormone replacement therapy; NC: natural cycle; RCT: randomised clinical trial.

Table 2. Quality assessment of randomised controlled trials by the modified JADAD scale (max. 7–points).

Study	Randomisation	Concealment of allocation	Double blinding	Withdrawals and dropouts	Score
Liu, P. 2021	1	0	0	1	2
Nazari, L. 2020	2	2	0	1	7
Nazari, L. 2022	2	2	2	1	7
Rageh, K. A. I. 2020	1	0	0	1	2
Safdarian, L. 2022	2	0	0	1	3
Zamaniyan, M. 2020	2	2	1	1	6

Table 3. Quality assessment of cohort studies by the Newcastle-Ottawa Quality Assessment Form (max. 9–points).

Study	Selection	Comparability	Outcome	Score
Coksuer, H. 2019	4	1	2	7
Liu, P. 2020	4	2	2	8
Tehraninejad, E. S. 2021	4	2	2	8
Xu, Y. 2022	4	2	2	8

Figure 1. Forest plot for clinical pregnancy rate.

PRP: platelet-rich plasma; CI: confidence interval.

Figure 2. Forest plot for implantation rate.

PRP: platelet-rich plasma; CI: confidence interval.

Figure 3. Forest plot for live birth rate

. PRP: platelet-rich plasma; CI: confidence interval.

Data availability statement

All data generated or analysed during this study are included in published articles.