Network meta-analysis on the efficacy of different interventions for treating thin endometrium

Area of Science:

• Reproductive Medicine
• Gynecology
• Infertility Treatment

Background:

• Thin endometrium affects 1-2.5% of assisted reproductive technology (ART) cycles.
• Current treatments for thin endometrium have varied and limited efficacy.
• Effective interventions are needed to improve ART outcomes.

Purpose of the Study:

• To systematically compare the efficacy of different interventions for thin endometrium.
• To evaluate improvements in endometrial thickness and clinical pregnancy rates.
• To guide clinical practice for thin endometrium treatment.

Main Methods:

• Network meta-analysis of 18 randomized controlled trials (RCTs).
• Included interventions: oral aspirin, Ding Kun Dan, intrauterine platelet-rich plasma (PRP), intrauterine granulocyte-macrophage colony-stimulating factor (G-CSF), intramuscular recombinant human growth hormone (rhGH), and neuromuscular electrical stimulation (NMES).
• Bayesian methods used for analysis, with Surface Under the Cumulative Ranking Curve (SUCRA) for ranking effectiveness.

Main Results:

• All interventions improved endometrial thickness compared to controls.
• Top interventions for thickness: G-CSF (SUCRA 78.48%), aspirin (SUCRA 70.89%), and PRP (SUCRA 68.14%).
• PRP (SUCRA 80.12%) was most effective for clinical pregnancy rates, followed by aspirin (SUCRA 70.29%) and Ding Kun Dan (SUCRA 62.79%).

Conclusions:

• Platelet-rich plasma (PRP) demonstrates significant potential for treating thin endometrium.
• PRP offers advantages in both endometrial thickness and clinical pregnancy rates.
• High-quality RCTs are recommended to further validate and optimize PRP interventions.