RESUMEN
Introduction: Treatment of refractory thin endometrium during IVF is a relatively challenging problem, considering that optimal endometrium thickness is one of the critical factors for successful implantation and pregnancy. Autologous intrauterine platelet-rich plasma (PRP) infusion is an adjuvant therapeutic alternative for enhancing the endometrial thickness (EMT) and echo pattern. It was shown that PRP could expand EMT and improve pregnancy outcomes with its high content of growth factors and cytokines, and its role in the regulation of the immunological interaction between the embryo and the endometrium. The aim of the study is to evaluate the effect of autologous PRP in improving the ongoing pregnancy rate in patients with refractory thin endometrium undergoing IVF. Material and methods: A prospective study in Ain Shams University Hospital including 66 infertile women with a refractory thin endometrium below 7 mm by ultrasound on the day of human chorionic gonadotropin injection in fresh embryo transfer (ET) cycle, who did not respond to standard medical therapies after more than 2 cycles of previous medical therapy, and who were candidates for IVF cycle were given intrauterine PRP. Results: A significant increase in EMT was noted and enhancement of endometrial pattern after intrauterine PRP infusion in the days of ovum pick-up and ET. There was also a significant increase in ongoing pregnancy, chemical pregnancy, clinical pregnancy, and implantation rates, while the miscarriage rate decreased after PRP infusion. Conclusions: Intrauterine PRP infusion improved ongoing pregnancy, chemical pregnancy, clinical pregnancy, and implantation rates, in addition to EMT and pattern on the days of ovum pick-up and ET, while the miscarriage rate significantly decreased.
RESUMEN
Ischemia-reperfusion (I/R) injury is a pathological process which magnifies with the ensuing inflammatory response and endures with the increase of oxidants especially during reperfusion. The present study was conducted to assess the possible modulatory effects of plumbagin, the active constituent extracted from the roots of traditional medicinal plant Plumbago zeylanica L., on the dire role of high mobility group box 1 (HMGB1) as well as the associated inflammation, oxidative stress and apoptotic cell death following hepatic I/R. Four groups of rats were included: sham-operated, sham-operated treated with plumbagin, I/R (30â¯min ischemia and 1â¯h reperfusion) and I/R treated with plumbagin. Pretreatment with plumbagin markedly improved hepatic function and structural integrity compared to the I/R group, as manifested by depressed plasma transaminases and lactate dehydrogenase (LDH) activities as well as alleviated tissue pathological lesions. Plumbagin prominently hampered HMGB1 expression and subsequently quelled inflammatory cascades, as nuclear factor κB (NF-κB), tumor necrosis factor-alpha (TNF-α) and myeloperoxidase (MPO) activity. It also interrupted reactive oxygen species (ROS)-HMGB1loop as evident by restored liver reduced glutathione (GSH), elevated glutathione peroxidase (GPx) activity, along with decreased liver lipid peroxidation. Simultaneously, plumbagin significantly ameliorated apoptosis by amending the mRNA expressions of both anti-apoptotic (Bcl-2) and pro-apoptotic (Bax). The present results revealed that plumbagin is endowed with hepatoprotective activity ascribed to its antioxidant, anti-inflammatory and anti-apoptotic properties which are partially mediated through dampening of HMGB1 expression.