Efficacy of using recombinant granulocyte colony-stimulating factor in IVF/ICSI protocols in patients with predicted suboptimal response to controlled ovarian stimulation

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Abstract

BACKGROUND: According to most studies, the efficacy of IVF/ICSI protocols in patients with suboptimal response was significantly lower than in women with normal response. However, methodological approaches optimizing the efficacy of IVF/ICSI protocols in patients with suboptimal response have not been developed.

AIM: The aim of this study was to evaluate the efficacy of using recombinant granulocyte colony-stimulating factor in IVF/ICSI protocols in women with predicted suboptimal response to controlled ovarian stimulation.

MATERIALS AND METHODS: This prospective study included 102 patients with predicted suboptimal response: treatment group (n = 34) and comparison group (n = 68). Controlled ovarian stimulation was performed according to the standard protocol with gonadotropin-releasing hormone antagonists. Women in treatment group daily received 60 mcg of recombinant granulocyte colony-stimulating factor subcutaneously from the onset of stimulation until the day of human chorionic gonadotropin blood test. The intergroup comparative analysis included clinical-anamnestic data, indicators of hormonal status, ovarian reserve, main characteristics of protocols stimulation, embryological data and the efficacy of IVF/ICSI programs.

RESULTS: In the treatment group, the number of retrieval oocytes was higher (8.1 ± 5.3 vs. 4.7 ± 2.6, respectively; p < 0.001), and the effective dose of follicle-stimulating hormone preparations was lower than in the comparison group (403.6 ± 351.1 IU vs. 694.3 ± 950.4 IU, respectively; p = 0.013). Besides, the number of mature oocytes (6.8 ± 5.2 vs. 3.7 ± 1.9, respectively; p < 0.01), 2PN zygotes (5.1 ± 3.9 vs. 2.8 ± 1.7, respectively; p < 0.01), and good quality embryos (3.4 ± 3.3 vs. 1.8 ± 1.5, respectively; p < 0.01) were also higher in the treatment group. Сlinical pregnancy rate in women receiving recombinant granulocyte colony-stimulating factor was significantly higher (41.2% vs. 22.1%, respectively; OR 2.47; 95% CI 1.01–6.03; p < 0.05).

CONCLUSIONS: Using recombinant granulocyte colony-stimulating factor improves the efficacy of IVF/ICSI protocols in women with predicted suboptimal response.

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About the authors

Cong T. Nguyen

Saint Petersburg State University

Author for correspondence.
Email: dr.tuan99999@gmail.com
ORCID iD: 0000-0002-4665-9025

MD

Russian Federation, 7–9, Universitetskaya nab., Saint Petersburg, 199034

Igor Yu. Kogan

Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: ikogan@mail.ru
ORCID iD: 0000-0002-7351-6900
SPIN-code: 6572-6450

MD, Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences

Russian Federation, 7–9, Universitetskaya nab., Saint Petersburg, 199034; Saint Petersburg

Dariko A. Niauri

Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: d.niauri@mail.ru
ORCID iD: 0000-0003-1556-248X
SPIN-code: 4384-9785

MD, Dr. Sci. (Med.), Professor

Russian Federation, 7–9, Universitetskaya nab., Saint Petersburg, 199034; Saint Petersburg

Manizha R. Makhmadaliyeva

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: 2563737@mail.ru
ORCID iD: 0000-0002-9578-8931

MD

Russian Federation, Saint Petersburg

Lyailya Kh. Dzhemlikhanova

Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: dzhemlikhanova_l@mail.ru
ORCID iD: 0000-0001-6842-4430
SPIN-code: 1691-6559

MD, Cand. Sci. (Med.)

Russian Federation, 7–9, Universitetskaya nab., Saint Petersburg, 199034; Saint Petersburg

Inna O. Krikheli

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: ikrikhely@gmail.com
ORCID iD: 0000-0002-5439-1727
SPIN-code: 7356-6189

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Natalya I. Tapilskaya

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott; Saint Petersburg State Pediatric Medical University

Email: tapnatalia@yandex.ru
ORCID iD: 0000-0001-5309-0087
Scopus Author ID: 23013489000

MD, Dr. Sci. (Med.), Professor

Russian Federation, Saint Petersburg; Saint Petersburg

Ksenia V. Obyedkova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: obedkova_ks@mail.ru
ORCID iD: 0000-0002-2056-7907
Scopus Author ID: 57201161145

MD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Zarina K. Abdulkadyrova

Saint Petersburg State University

Email: spb.zarika.los@mail.ru
ORCID iD: 0000-0002-2154-298X

MD, Cand. Sci. (Med.)

Russian Federation, 7–9, Universitetskaya nab., Saint Petersburg, 199034

Toan Thai Tran

Hanoi National University of Education

Email: tstranthaitoan@gmail.com
ORCID iD: 0000-0002-7263-6150

Cand. Sci. (Biol.)

Viet Nam, Hanoi

Irina D. Mekina

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: iagmail@ott.ru
ORCID iD: 0000-0002-0813-5845
SPIN-code: 4682-8590

Cand. Sci. (Biol.)

Russian Federation, Saint Petersburg

Elena A. Lesik

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: lesike@yandex.ru
ORCID iD: 0000-0003-1611-6318

Cand. Sci. (Biol.)

Russian Federation, Saint Petersburg

Evgenia M. Komarova

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: evgmkomarova@gmail.com
ORCID iD: 0000-0002-9988-9879
SPIN-code: 1056-7821

Cand. Sci. (Biol.)

Russian Federation, Saint Petersburg

Maria A. Ishchuk

The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: mashamazilina@gmail.com
ORCID iD: 0000-0002-4443-4287
Scopus Author ID: 57194177084
Russian Federation, Saint Petersburg

Alexandr M. Gzgzyan

Saint Petersburg State University; The Research Institute of Obstetrics, Gynecology and Reproductology named after D.O. Ott

Email: agzgzyan@gmail.com
ORCID iD: 0000-0003-3917-9493
SPIN-code: 6412-4801

MD, Dr. Sci. (Med.)

Russian Federation, 7–9, Universitetskaya nab., Saint Petersburg, 199034; Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Distribution of infertility factors in the examined female patients

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3. Fig. 2. Characteristics of the main ovarian reserve indicators of the examined female patients

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4. Fig. 3. Structural characteristics of the response to controlled ovarian stimulation in female patients who received and did not receive granulocyte colony-stimulating factor preparations

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5. Fig. 4. Comparison of IVF/ICSI program efficiency in female patients who received and did not receive granulocyte colony-stimulating factor (rG-CSF) preparations in cycles of controlled ovarian stimulation

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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