Intrauterine use of granulocyte colony-stimulating factor in patients with thin endometrium in frozen embryo transfer programs


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Objective. To determine the efficacy of intrauterine use of granulocyte colony-stimulating factor (G-CSF) for the increase of endometrial thickness and pregnancy rates in patients with thin endometrium in frozen embryo transfer programs. Materials and methods. The main group included 15 patients with thin endometrium, which was refractory to standard methods of treatment; embryo transfer cycles were cancelled several times due to insufficient endometrial thickness in these patients. In addition to hormone replacement therapy (HRT), the patients were given an intrauterine injection of G-CSF on the 5-6th and 12-13th days of the menstrual cycle. The control group included 17 patients with thin endometrium, they received only HRT. The endometrial thickness was measured by ultrasound on the 14-15th and 20-21st (the day of embryo transfer) days of the menstrual cycle. The primary outcome was an increase in endometrial thickness greater than 7 mm on the day of embryo transfer, the secondary outcome was pregnancy rate. Results. Endometrial thickness greater than 7mm was observed in 7 patients (46.67%) in G-CSF group, and in 8 (47.06%) patients in the control group; the difference was not statistically significant (p=0.983). The average increase in endometrial thickness compared to the previous cycle was 0.6 mm. The average thickness of the endometrium was 7.32 mm in the main group. Embryo transfer was performed in 8 (53.33%) patients in G-CSF group, pregnancy occurred in 4 (50%) patients, clinical pregnancy in 3 (37.5%) patients, one patient had a biochemical pregnancy. At the time of the article’s publication there were two (25%) livebirths and one ongoing pregnancy. In the control group, the average thickness of the endometrium was 6.9 mm. Embryo transfer was performed in 4 patients (23.53%). But no pregnancy was achieved in any of the patients, the difference was not statistically significant (p=0.84). Conclusion. Despite the results that were not statistically significant, patients in G-CSF group showed a tendency for the increase in endometrial thickness and pregnancy rates, as well as the decrease in embryo transfer cycle cancellations. It is worth conducting studies with a larger sample of patients to obtain more reliable results.

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作者简介

Lana Dzhincharadze

Academician V.I. Kulakov National Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: lanachka@list.ru
graduate student of 1st Gynecology department

Aydar Abubakirov

Academician V.I. Kulakov National Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nondoc555@yahoo.com
PhD, Head of 1st Gynecology department

Nona Mishieva

Academician V.I. Kulakov National Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nondoc555@mail.ru
PhD, Senior researcher of 1st Gynecology department

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