The efficacy of intrauterine instillation of granulocyte colony-stimulating factor in infertile women with a thin endometrium: A pilot study

Abstract

ObjectiveThe study aimed to investigate the efficacy of intrauterine instillation of granulocyte colony-stimulating factor (G-CSF) on the day of ovulation triggering or oocyte retrieval in infertile women with a thin endometrium.MethodsFifty women whose endometrial thickness (EMT) was ≤8 mm at the time of triggering during at least one previous in vitro fertilization (IVF) cycle and an index IVF cycle were selected. On the day of triggering (n=12) or oocyte retrieval (n=38), 300 µg of G-CSF was instilled into the uterine cavity.ResultsIn the 50 index IVF cycles, the mean EMT was 7.2±0.6 mm on the triggering day and increased to 8.5±1.5 mm on the embryo transfer day (p<0.001). The overall clinical pregnancy rate was 22.0%, the implantation rate was 15.9%, and the ongoing pregnancy rate was 20%. The clinical pregnancy rate (41.7% vs. 15.8%), the implantation rate (26.7% vs. 11.7%), and the ongoing pregnancy rate (41.7% vs. 13.2%) were higher when G-CSF was instilled on the triggering day than when it was instilled on the retrieval day, although this tendency was likewise not statistically significant. Aspects of the stimulation process and mean changes in EMT were similar in women who became pregnant and women who did not.ConclusionIntrauterine instillation of G-CSF enhanced endometrial development and resulted in an acceptable pregnancy rate. Instillation of G-CSF on the triggering day showed better outcomes. G-CSF instillation should be considered as a strategy for inducing endometrial growth and good pregnancy results in infertile women with a thin endometrium.

Association between induced abortion history and later in vitro fertilization outcomes

“…It starts with the apposition of the blastocyst at the uterine endometrium and then attachment to the endometrial surface epithelium . Several studies have shown that a thin endometrium adversely affects the pregnancy rate in IVF …”

“…9 Several studies have shown that a thin endometrium adversely affects the pregnancy rate in IVF. [10][11][12] After surgical abortion, inflammation can occur in both the endometrium and the oviduct. Endometritis is chronic inflammation of the inner lining of the uterine cavity, and leads to abnormal uterine bleeding, recurrent spontaneous abortion, and infertility.…”

G-CSF and stem cell therapy for the treatment of refractory thin lining in assisted reproductive technology

“…After intrauterine G-CSF treatment, the endometrial lining significantly increased in the cohort, with 3/12 (20%) patients subsequently conceiving [30]. Most recently, Lee and colleagues also demonstrated that intrauterine G-CSF (300 μg) on either trigger day or retrieval day significantly increased the EMT in patients with thin lining, resulting in pregnancy rate of 22.0% [31]. Interestingly, there was a trend for higher implantation, clinical pregnancy, and ongoing pregnancy rates when the G-CSF was instilled on the day of HCG trigger vs. day of egg retrieval [31].…”

Effect of&nbsp;Intrauterine Recombinant Human Granulocyte Colony-stimulating Factor&nbsp;(rhG-CSF) Infusion on Pregnancy Outcomes in Patients With Repeated Implantation Failure During Freeze-Thaw Embryo Transfer Cycles: A Retrospective Cohort Study

“…Several studies with different results have assessed the effect of G-CSF on endometrial thickness and IVF success [16,17]. In the studies of N. Gleicher et al [18]and Dayong Lee et al [19], the endometrial thickness, implantation and pregnancy rates were signi cantly higher in IVF patients treated with G-CSF, whereas in the studies of Eftekhar M et al [20] and Shivani Jain et al [21], treatment with G-CSF did not affect endometrial thickness and pregnancy outcomes in IVF patients. This difference may be related to the inconsistent with selection criteria of patients.…”