Granulocyte-colony stimulation factor (G-CSF): an option to improve in vitro fertilization (IVF) outcomes in poor responders

Abstract

To assess the effectiveness of granulocyte colony-stimulating factor for improving the ovary response in IVF cycles of poor responders women. It was a prospective, therapeutic, self-controlled clinical trial. Between July and December 2011 we selected 10 women that would be submitted to an IVF cycle. The inclusion criteria were: 2 previous failures in cycles with less than 3 oocytes and early follicular phase serum levels of FSH within normal limits. All of them were submitted to the same protocol for ovarian stimulation used in their last cycle, with the association of 0,25 ml Filgrastim 300 mcg/ml subcutaneous every other day from the day of the beginning of ovary stimulation and repeated for 4 times. The study variables were: number of oocytes, mature oocytes and third day embryos, expressed as mean; and pregnancy rate, expressed as percentage. These variables were compared to the last cycle of the same women. T student test was performed to compare means. Pregnancy rate was compared using Fisher's exact test. Before G-CSF, it were found means of 1,1 oocytes, 0,9 mature oocytes, 0,6 embryos, without any pregnancy. After G-CSF treatment, it was observed 2,4 oocytes, 1,7 mature oocytes, 1,1 embryos and pregnancy rate of 20%. We observed an increasing in number of retrieved oocytes, mature oocytes and embryos in the group that used G-CSF in comparison to those seen in the preceding cycles. All the results haven't had statistical significance probably due to a small number of cases. In poor responders, G-CSF adjuvant therapy seems to improve the number of retrieved oocytes, mature oocytes, embryos and pregnancy rate. Nevertheless, larger studies are needed to confirm the effectiveness of this approach for poor responders.