Enrollment
pathospermia, systemic blood diseases, failure and/or ET cancellation, thin endometrial infertility, genital anomalies
PREMATURE OVARIAN FAILURE, PROLIFERATIVE, COAGULOPATHY
The study was carried out in V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology from October 2018 to March 2021. The inclusion criteria were as follows: age 18–40 years, normal karyotype, normal karyotype of the partner, regular ovulatory and menstrual cycle, endometrium < 7 mm thick as measured at implantation window, availability of ≥ 2 vitrified blastocysts of good quality, and a history of implantation failure and/or ET cancellation due to insufficient endometrial thickness. The exclusion criteria were pathospermia in partner, the use of donor gametes, premature ovarian failure, internal genital anomalies, systemic blood diseases and coagulopathy, hemoglobin < 100 g/L, platelets < 100 × 10The study encompassed 115 patients admitted for the treatment of thin endometrial infertility (endometrial thickness 7 mm or less at implantation window).The participants were divided into groups by simple randomization (sequentially numbered containers). Group 1 (the control, n = 30) received electrical impulse therapy using a BTL-4000 Premium G device starting from day 5–7 of menstrual cycle for 10–12 days daily. Group 2 (n = 42) received single intraendometrial injections of autologous PRP: a 35–40 mL aliquot was injected under hysteroscopic control, via endoscopic needle, during proliferative phase (day 6–9) of menstrual cycle preceding ET. Group 3 (n = 38) received a two-step preparatory regimen spanning two consecutive menstrual cycles: at first, the patients received electrical impulse therapy identically with Group 1; over the second cycle, the patients received autologous PRP injections identically with Group 2. Group 4 (n = 5) received single intraendometrial injections of the minimally manipulated autologous endometrial cells suspended in autologous PRP: a 35–40 mL aliquot was injected under hysteroscopic control, via endoscopic needle, during proliferative phase (day 6–9) of menstrual cycle preceding ET. All patients underwent ultrasonography of pelvic organs and a Doppler ultrasound scan of uterine microcirculation. This sample size was approved by the ethics committees of the institutes. Additional information is available in Supplementary material.