DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20191200

Granulocyte colony stimulating factor in COS-IUI cycles

Pradnya Devdas Shetty, Nikita Lad, Pallavi Vishwekar, Mamta Vijay Shivtare

Abstract


Background: An unresolved assisted reproductive technique problem is the unresponsive, thin endometrium. Approximately 0.6%-0.8% of patients do not reach the minimum thickness. Using endometrial co culture, G-CSF>130pg/mL was associated with significantly improved pregnancy rate in ART cycles. This is a retrospective study that included all unexplained infertility cycles with controlled ovulation stimulation –IUI protocols. Aim was to note the effects of G-CSF on thin endometrium and pregnancy rate in G-CSF administered COS-IUI cycles.

Methods: This study was done in the IVF department of Dr D Y Patil University, Navi Mumbai, India. Thin endometrium was defined as ET<7mm on transvaginal ultrasound. Clomiphene citrate was used for ovulation induction in strengths of 100mg or 50mg on day 2 of their cycle based on the antral follicle count. Trigger used was injection 10,000µg urinary hCG. On the same day when the trigger injection was given, 300 units G-CSF was instilled into the uterus. Post 36 hours IUI was done under aseptic precautions .After 16 days β-hCG levels were done to determine whether there is a pregnancy.

Results: In present study,200 COS-IUI cycles were analysed.50 cycles showed a thin endometrium and in them G-CSF was used. The chemical pregnancy rates was 32%, the intrauterine pregnancy rate was 28%, ectopic pregnancy rate was 4%.

Conclusions: Present study concluded that G-CSF increases ET significantly in COS-IUI cycles in the event of thin endometrium. In view of small cohort size further larger randomized controlled trials may be required  to substantiate the above conclusions.


Keywords


COS-IUI, G-CSF, IUI protocols

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References


Harry H. Infertility. Clinic Obstet Gynecol.54(4):642-3.

Kunicki M, Łukaszuk K, Woclawek-Potocka I, Liss J, Kulwikowska P, Szczyptańska J. Evaluation of granulocyte colony-stimulating factor effects on treatment-resistant thin endometrium in women undergoing in vitro fertilization. BioMed research international. 2014;2014.

Al-Ghamdi A, Coskun S, Al-Hassan S, Al-Rejjal R, Awartani K. The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reproduct Biol Endocrinol. 2008;6(1):37.

Salmassi A, Schmutzler AG, Schaefer S, Koch K, Hedderich J, Jonat W et al. Is granulocyte colony-stimulating factor level predictive for human IVF outcome?. Human Reproduction. 2005 May 12;20(9):2434-40.

Spandorfer SD, Barmat LI, Liu HC, Mele C, Veeck L, Rosenwaks Z. Granulocyte Macrophage‐Colony Stimulating Factor Production by Autologous Endometrial Co‐Culture Is Associated with Outcome for In Vitro Fertilization Patients with a History of Multiple Implantation Failures. Am J Reproduct Immunol. 1998;40(5):377-81.

Agerholm I, Loft A, Hald F, Lemmen JG, Munding B, Sørensen PD et al. Culture of human oocytes with granulocyte-macrophage colony-stimulating factor has no effect on embryonic chromosomal constitution. Reproductive biomedicine online. 2010;20(4):477-84.

Jensen JR, Witz CA, Schenken RS, Tekmal RR. A potential role for colony-stimulating factor 1 in the genesis of the early endometriotic lesion. Fertil Steril. 2010;93(1):251-6.

Gleicher N, Kim A, Michaeli T, Lee HJ, Shohat-Tal A, Lazzaroni E et al. A pilot cohort study of granulocyte colony-stimulating factor in the treatment of unresponsive thin endometrium resistant to standard therapies. Human Reprod. 2012;28(1):172-7.