Abstract
Background: Granulocyte-colony stimulating factor (G-CSF) is an innovative therapy in reproductive medicine. Although its mechanisms of action have remained unknown, G-CSF seems to be effective in the case of recurrent abortion or implantation failure and thin endometrium. Objectives: This study was conducted to investigate whether subcutaneous administration of G-CSF has any effect on pregnancy outcome after assisted reproductive technology (ART). Methods: Fifty women with male infertility factors undergoing ART treatment were enrolled and stimulated with the standard long protocol. The G-CSF group of women received one dose of subcutaneous G-CSF (Filgrastim, 300 µg/1 mL) on the day of embryo transfer and again two days later while the placebo group received normal saline. Results: Seventeen patients had a positive β-human chorionic gonadotropin concentration after embryo transfer (8 and 9 in G-CSF and placebo groups, respectively) although the difference was not statistically significant. In addition, spontaneous abortion occurred in three patients (1 patient in the G-CSF group vs. 2 patients in the placebo group). Conclusion: Overall, although G-CSF failed to affect the endometrial thickness, as well as implantation, or clinical pregnancy rates, a lower prevalence of abortion in G-CSF group may be due to the positive effect of G-CSF administration on the endometrium as compared to the placebo group.
Highlights
Despite all the developments in assisted reproductive technology (ART), many morphologically normal embryos fail to implant, which may be a consequence of embryo or uterine factors [1]
17 subjects had a positive β-human chorionic gonadotropin concentration after their embryo transfer, including 8 (44.4%) and 9 (50.0%) cases in Granulocyte-colony stimulating factor (G-CSF) and placebo groups, respectively, and clinical pregnancy was established for all these subjects
More recently, G-CSF is found to have an essential role in innovative therapy in reproductive medicine, CSF2/GMCSF and CSF3/G-CSF [22]
Summary
Despite all the developments in assisted reproductive technology (ART), many morphologically normal embryos fail to implant, which may be a consequence of embryo or uterine factors [1]. Human endometrium undergoes significant changes in order to prepare for implantation, and in this process, immune cells and their secreted substances such as Granulocyte-colony stimulating factor (G-CSF) play an important role in the luteal phase [3]. G-CSF is considered as an anti-apoptosis protein, which inhibits apoptosis in endometrial cells It increases the number of endometrial blood vessels in patients with thin endometrium, and prevents any damage. Objectives: This study was conducted to investigate whether subcutaneous administration of G-CSF has any effect on pregnancy outcome after assisted reproductive technology (ART). Conclusion: Overall, G-CSF failed to affect the endometrial thickness, as well as implantation, or clinical pregnancy rates, a lower prevalence of abortion in G-CSF group may be due to the positive effect of G-CSF administration on the endometrium as compared to the placebo group.
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