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

Abstract

The efficacy of two granulocyte colony-stimulating factor (G-CSF) protocols for thin endometrium were investigated. Eighty-two patients were diagnosed with thin endometrium (<7 mm). Thirty patients with previously cancelled embryo transfers received intrauterine G-CSF in subsequent frozen embryo transfer (FET) cycles. Patients were divided into the G-CSF only and G-CSF with endometrial scratch subgroups. Compared with previous cycles, endometrial thickness increased from 5.7 ± 0.7 mm to 8.1 ± 2.1 mm after G-CSF treatment (P < 0.001). Endometrial thickness increases were not significantly different between the two subgroups. The G-CSF with endometrial scratch subgroup established nominally higher though non-significant clinical pregnancy and live birth rates than the G-CSF only subgroup (53.8 % versus 42.9% and 38.5% versus 28.6%, respectively). Fifty-two patients underwent FET despite edometrial thickness less than 7 mm, and were included as controls. Significantly higher embryo implantation and clinical pregnancy rates were observed in the G-CSF group compared with the control group (31.5% versus 13.9%; P < 0.01; 48.1% versus 25.0%; P = 0.038, respectively). Endometrial scracth did not impair G-CSF treatment for thin endometrium and favoured pregnancy and live birth rates. For patients with thin endometrium, embryo transfer cancellation and G-CSF treatment in subsequent FET cycles is beneficial.

Granulocyte colony-stimulating factor in repeated IVF failure, a randomized trial

“…Since then, several studies with controversial results have evaluated the effect of GCSF on endometrial thickness and IVF success (Scarpellini & Sbracia 2012, Gleicher et al 2013, Barad et al 2014, Eftekhar et al 2014, Kunicki et al 2014, Li et al 2014, Xu et al 2015. In the studies of Scarpellini and coworkers and Xu and coworkers, the implantation and pregnancy rates were significantly higher in IVF patients treated with GCSF (Scarpellini & Sbracia 2012, Xu et al 2015, whereas in the studies of Barad and coworkers and Li and coworkers, treatment with GCSF did not affect endometrial thickness, implantation, or pregnancy rates in IVF patients (Barad et al 2014, Li et al 2014.…”

The Effect of G-CSF on Infertile Women Undergoing IVF Treatment

“…On the basis of the similar results of Xu et al, our latest metaanalysis was conducted to investigate the effect of G-CSF on pregnant outcomes with six studies and 607 participants involved [1,7]. These results indicated that G-CSF might have the capacity to improve pregnancy outcomes, especially for patients with the thin endometrium or repeated IVF failure.…”

“…However, for patients with thin endometrium, the production of G-CSF was influenced by abnormal function of endometrium and the mechanism for affecting the implantation should be further explored. For endometrial thickness, the studies by Xu et al and Li et al did not perform subgroup analyses according to pregnancy outcome, even though none of them detected the difference [1,3].…”

“…We read with interest the research by Xu et al [1] exploring the efficacy of intrauterine instillation granulocyte colonystimulating factor (G-CSF) for thin endometrium. Compared with the control group, significantly higher embryo implantation and clinical pregnancy rates were observed in the G-CSF group (31.5% vs. 13.9%; 48.1% vs. 25.0%; respectively).…”

Granulocyte Colony Stimulating Factor for Treatment of Thin Endometrium in Assisted Reproduction Technology Cycles

“…Out of 82 women who had previously canceled cycles, 30 received G-CSF. 37 This group was further subdivided into two groups-one received G-CSF only and second group underwent endometrial scratching along with G-CSF. The remaining 50 women served as a control.…”