Granulocyte colony-stimulating factor (G-CSF): a mediator in endometrial receptivity for a patient with polycystic ovary (PCO) undergoing in vitro maturation (IVM)

Abstract

SUMMARYProliferative and secretory changes at the endometrial lining are the result of a complex intrauterine environment where sex steroid hormones and different local factors play an important role for endometrial thickening. Optimal endometrial thickness reflects an adequate maturation which is a key factor for embryo implantation. Here, we present a case of a woman with polycystic ovary who was treated using in vitro maturation (IVM) techniques. In addition, this patient showed a dyssynchrony between the endometrial phase characterised by endometrial thinning and the embryo development which had a negative impact for embryo implantation. A protocol using uterine perfusion of granulocyte colony-stimulating factor (G-CSF) was performed as an alternative treatment for the unresponsive endometrium. We found that uterine infusion of G-CSF quickly increased endometrial thickness resulting in a successful pregnancy and healthy born baby. These results suggest that G-CSF is a factor that participates during endometrial remodelling enhancing the synchronisation between uterine environment and embryo development. BACKGROUND

Treatment of thin endometrium with autologous platelet-rich plasma: a pilot study

“…According to this hypothesis, local infusion of PRP that contains several growth factors and cytokines may improve endometrial growth and receptivity. PRP is collected from autologous blood sample, so in comparison to G-CSF, PRP is more accessible and affordable (Gleicher et al , 2011; Lucena & Moreno-Ortiz, 2013). …”

Granulocyte colony stimulating factor treatment of resistant thin endometrium in women with frozen-thawed blastocyst transfer

“…Authors observed a 19.1% ongoing clinical pregnancy rate and concluded that G-CSF is useful in the treatment of chronically thin endometrium [Gleicher et al 2013]. A case study by Lucena and Moreno-Ortiz [2013] reported an increase in endometrial thickness after infusing 300 ug of G-CSF at the time of oocyte retrieval. Similar results were observed in a nonrandomized clinical trial conducted by Tehraninejad et al [2015] on a group of fifteen infertile women undergoing fresh IVF cycles (infusion of 300 ug/1 mL of G-CSF at the day of oocyte retrieval).…”

Two protocols to treat thin endometrium with granulocyte colony-stimulating factor during frozen embryo transfer cycles

“…Since 2011, seven studies (Barad et al, 2014;Gleicher et al, 2011Gleicher et al, , 2013Kunicki et al, 2014;Li et al, 2014;Lucena and Moreno-Ortiz, 2013;Zhao et al, 2013) have evaluated the effect of G-CSF on endometrium and IVF outcomes ( Table 3). Consistent with previously reported data (Gleicher et al, 2013;Kunicki et al, 2014), TEM increased significantly after G-CSF treatment in the same cycles.…”