Effect of granulocyte colony stimulating factor (G-CSF) on IVF outcomes in infertile women: An RCT

Abstract

Background: Despite major advances in assisted reproductive techniques, the implantation rates remain relatively low. Some studies have demonstrated that intrauterine infusion of granulocyte colony stimulating factor (G-CSF) improves implantation in infertile women. Objective: To assess the G-CSF effects on IVF outcomes in women with normal endometrial thickness. Materials and methods : In this randomized controlled clinical trial, 100 infertile women with normal endometrial thickness who were candidate for IVF were evaluated in two groups. Exclusion criteria were positive history of repeated implantation failure (RIF), endocrine disorders, severe endometriosis, congenital or acquired uterine anomaly and contraindication for G-CSF (renal disease, sickle cell disease, or malignancy). In G-CSF group (n=50), 300 µg trans cervical intrauterine of G-CSF was administered at the oocyte retrieval day. Controls (n=50) were treated with standard protocol. Chemical, clinical and ongoing pregnancy rates, implantation rate, and miscarriage rate were compared between groups. Results: Number of total and mature oocytes (MII), two pronuclei (2PN), total embryos, transferred embryos, quality of transferred embryos, and fertilization rate did not differ significantly between two groups. So there were no significant differences between groups in chemical, clinical and ongoing pregnancy rate, implantation rate, and miscarriage rate Conclusion: our result showed in normal IVF patients with normal endometrial thickness, the intrauterine infusion of G-CSF did not improve pregnancy outcomes.

Intrauterine instillation of granulocyte colony stimulating factor for infertile women with thin endometrium in intrauterine insemination cycle: a non-randomized clinical trial

“…18 However, in some trials, such as the Eftekhar et al study, there was no improvement in ET after intrauterine G-CSF instillation. 19 They came to the conclusion that the use of G-CSF was ineffective in increasing the endometrium thickness among infertile women undergoing IVF because the difference in ET between the study and control group was similar in the studies by Aleyasin et al and Barad et al as well. 17,20 Only two of the 20 patients in group A of our study (10%) were pregnant after utilizing G-CSF on the day of the ovarian trigger and only one of the 20 patients in group B (5%) were pregnant after receiving normal saline.…”

Research on Recent Progress in the Treatment of Thin Endometrium

“…In all subjects, endometrial ply was 6.74 mm before G-CSF injection and enhanced greatly to 8.42 mm after infusion [12]. In another non-randomized interventional clinical experiment, Eftekhar et al [13] compared the effects of in utero G-CSF treatment and immediate embryo shift in suffers with endometrium (<7 mm). All suffers were treated with oral oestrogen and transvaginal sildenafil and on day 12 or 13, patients in the G-CSF group would receive intrauterine G-CSF therapy.…”

Endometrial thickness: How thin is too thin?

“…The use of G-CSF was first reported in 2011 in a series of 4 donor oocyte recipients with a history of a thin lining, all of whom conceived after G-CSF infusion (92). Since that time, many studies have been published on the use of G-CSF as an add-on for several indications, including a thin endometrium, recurrent implantation failure, and endometriosis (93,94). The proposed mechanism of G-CSF is to promote endometrial regeneration and improve vascularization.…”