DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20201527

Retrospective analysis of intrauterine granulocyte colony-stimulating factor in controlled ovarian stimulation with intrauterine insemination cycle

Navinchandra R. Nayak, Madhumeetha T., Mangala Gowri Hegde, Aparna C. Aravind, Ritu Sharma A., Shwetha Ballal K.

Abstract


Background: Persistent thin endometrium affects <1% of patients. Various treatments have been proposed with no satisfactory results. GCSF is one such treatment modality which improves endometrial thickness and implantation. Aim of this study was to analyse the effects of dose and the site of instilling intrauterine G-CSF in COS IUI cycles in patients with unexplained infertility and to note the pregnancy rates among them.

Methods: It is a 3-year retrospective study done in obstetrics and gynecology department of AJ Institute of Medical Sciences and Research Centre, that included all unexplained infertility cycles with controlled ovulation stimulation-IUI protocols where for a thin endometrium GCSF was used. The method of ovarian stimulation, the drug and dose used, the trigger for ovulation and the ovarian and endometrial response was noted. The day of the intrauterine GCSF and the dose and the site of instillation was noted. The endometrial response to GCSF the outcome for pregnancy was noted. All the data was analyzed statistically.

Results: Significant endometrial response was seen with a dose of 100 mg,150 mg and 300 mg. Pregnancy outcome was better when GCSF was instilled just above the level of the os. GCSF instilled at the level of the fundus increases the possibility of ectopic pregnancy.

Conclusions: Instillation of GCSF of 100 mg dosage just above the os; is a safe and effective method for improving the endometrial thickness and increasing pregnancy rate.


Keywords


Endometrial thickness, Granulocyte colony stimulating factor, Intra uterine insemination, Pregnancy outcome, Unexplained infertility

Full Text:

PDF

References


Sarvi F, Arabahmadi M, Alleyassin A, Aghahosseini M, Ghasemi M. Effect of increased endometrial thickness and implantation rate by granulocyte colony-stimulating factor on unresponsive thin endometrium in fresh in vitro fertilization cycles: a randomized clinical trial. Obstet Gynecol Int. 2017;3596079.

Speroff L, Fritz MA, editors. Clinical gynecologic endocrinology and infertility. lippincott Williams & wilkins; section 4; Speroff. 8th edition; 2005:185:1167.

Samara N, Bentov Y. Current Strategies to Manage a Thin Endometrium. Womens Health Gynecol. 2016;2(4):003e.

Eftekhar M, Hosseinisadat R, Baradaran R, Naghshineh E. Effect of granulocyte colony stimulating factor (G-CSF) on IVF outcomes in infertile women: An RCT. Inter J Reprod BioMed. 2016;14(5):341.

Gleicher N, Vidali A, Barad DH. Successful treatment of unresponsive thin endometrium. Fertil Steril. 2011;95(6):2123-e13.

Kamath MS, Lele P. Granulocyte colony stimulating factor for treatment of thin endometrium in assisted reproduction technology cycles. Int J Infertil Fetal Med. 2015;6(3):97-102.

Barad DH, Yu Y, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, ET AL. A randomized clinical trial of endometrial perfusion with granulocyte colony-stimulating factor in in vitro fertilization cycles: impact on endometrial thickness and clinical pregnancy rates. Fertil Steril. 2014;101(3):710-5.

Tehraninejad E, Tanha FD, Asadi E, Kamali K, Aziminikoo E, Rezayof E. G-CSF intrauterine for thin endometrium, and pregnancy outcome. J Family Reprod Health. 2015;9(3):107.

Mishra VV, Choudhary S, Sharma U, Aggarwal R, Agarwal R, Gandhi K, et al. Effects of granulocyte colony-stimulating factor (GCSF) on persistent thin endometrium in frozen embryo transfer (FET) cycles. The J Obstet Gynecol India. 2016;66(1):407-11.

Eftekhar M, Tabibnejad N, Tabatabaie AA. The thin endometrium in assisted reproductive technology: an ongoing challenge. Middle East Fertil Society J. 2018;23(1):1-7.

Eftekhar M, Sayadi M, Arabjahvani F. Transvaginal perfusion of G-CSF for infertile women with thin endometrium in frozen ET program: A non-randomized clinical trial. Iranian J Reprod Med. 2014;12(10):661.

Aleyasin A, Abediasl Z, Nazari A, Sheikh M. Granulocyte colony-stimulating factor in repeated IVF failure, a randomized trial. Reprod. 2016;151(6):637-42.

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 Res Inter. 2014;2014.

Zhang L, Xu WH, Fu XH, Huang QX, Guo XY, Zhang L, et al. Therapeutic role of granulocyte colony-stimulating factor (G-CSF) for infertile women under in vitro fertilization and embryo transfer (IVF-ET) treatment: a meta-analysis. Arch Gynecol Obstet. 2018;298(5):861-71.