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http://dx.doi.org/10.5653/cerm.2016.43.4.240

The efficacy of intrauterine instillation of granulocyte colony-stimulating factor in infertile women with a thin endometrium: A pilot study  

Lee, Dayong (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Jo, Jae Dong (Ellemedi Women Clinic)
Kim, Seul Ki (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Jee, Byung Chul (Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
Kim, Seok Hyun (Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul National University College of Medicine)
Publication Information
Clinical and Experimental Reproductive Medicine / v.43, no.4, 2016 , pp. 240-246 More about this Journal
Abstract
Objective: The study aimed to investigate the efficacy of intrauterine instillation of granulocyte colony-stimulating factor (G-CSF) on the day of ovulation triggering or oocyte retrieval in infertile women with a thin endometrium. Methods: Fifty women whose endometrial thickness (EMT) was ${\leq}8mm$ at the time of triggering during at least one previous in vitro fertilization (IVF) cycle and an index IVF cycle were selected. On the day of triggering (n = 12) or oocyte retrieval (n = 38), $300{\mu}g$ of G-CSF was instilled into the uterine cavity. Results: In the 50 index IVF cycles, the mean EMT was $7.2{\pm}0.6mm$ on the triggering day and increased to $8.5{\pm}1.5mm$ on the embryo transfer day (p< 0.001). The overall clinical pregnancy rate was 22.0%, the implantation rate was 15.9%, and the ongoing pregnancy rate was 20%. The clinical pregnancy rate (41.7% vs. 15.8%), the implantation rate (26.7% vs. 11.7%), and the ongoing pregnancy rate (41.7% vs. 13.2%) were higher when G-CSF was instilled on the triggering day than when it was instilled on the retrieval day, although this tendency was likewise not statistically significant. Aspects of the stimulation process and mean changes in EMT were similar in women who became pregnant and women who did not. Conclusion: Intrauterine instillation of G-CSF enhanced endometrial development and resulted in an acceptable pregnancy rate. Instillation of G-CSF on the triggering day showed better outcomes. G-CSF instillation should be considered as a strategy for inducing endometrial growth and good pregnancy results in infertile women with a thin endometrium.
Keywords
Endometrium; Granulocyte colony-stimulating factor; In vitro fertilization;
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