Value of intrauterine platelet-rich concentrates in patients with intrauterine adhesions after hysteroscopy: A systematic review and meta-analysis of randomized controlled trials

Objective: To evaluate the value of intrauterine platelet-rich concentrates among patients with intrauterine ad-hesions (IUAs) after hysteroscopic adhesiolysis. Methods: Four different databases (PubMed, Cochrane Library, Scopus, and ISI web of science) were searched for the available studies from inception to November 2021. We selected randomized clinical trials (RCTs) that compared platelet-rich concentrates in the intervention group versus no injection of platelet-rich concentrates in the control group among women with intrauterine adhesions after operative hysteroscopy. Revman software was utilized for performing our meta-analysis. Our primary outcomes were the adhesion score and incidence of recurrence of severe intrauterine adhesions postoperatively. Our secondary outcomes were the clinical preg-nancy rate, menstrual flow duration in days, and menstrual flow amount (number of pads). Results: Five RCTs met our inclusion criteria with a total number of 329 patients. We found that platelet-rich concentrates were linked to a significant reduction in the postoperative adhesion score (MD =-1.00, 95% CI [-1.68,-0.32], p = 0.004). Moreover, there was a significant reduction in the incidence of severe IUAs recur-rence among the platelet-rich concentrates group (7.6%) compared to the control group (23.4%) after hyster-oscopy (p = 0.001). The clinical pregnancy rate was significantly increased among the platelet-rich concentrates group (37.1%) in comparison with the control group (20.7%) after hysteroscopic adhesiolysis (p = 0.008). There were significant improvements in the menstrual flow duration and amount among the platelet-rich concentrates group (p < 0.001). Conclusions: Intrauterine placement of platelet-rich concentrates is an effective method for the treatment of in-trauterine adhesions after hysteroscopy.