Evaluation of granulocyte colony-stimulating factor on the treatment of thin endometrium during frozen-thawed embryo transfer cycles: a retrospective cohort study

Abstract

The aim of this study was to evaluate the effect of granulocyte colony-stimulating factor (G-CSF) on thin endometrium (≤7 mm) in women undergoing frozen-thawed embryo transfer (FET). This retrospective cohort study includes 271 infertile patients with thin endometrium. 117 patients who received intrauterine perfusion of G-CSF before the day of administration of progesterone were defined as G-CSF group, whereas 154 patients who refused to use G-CSF treatment were defined as control group. In the G-CSF group, significantly higher endometrial thickness was observed after G-CSF perfusion (p < .001). When we divided the G-CSF group into two subgroups according to whether they conceived, the endometrial thickness increased from 6.02 ± 0.92 mm to 6.98 ± 1.20 mm in the conception group (p < .001) and from 6.21 ± 0.96 mm to 6.87 ± 1.16 mm in the non-conception group (p < .001). However, there were no significant differences between the two subgroups in respect to the endometrial thickness both before and after G-CSF perfusion. The implantation rate, hCG positive rate and clinical pregnancy rate were similar between G-CSF group and control group. Thus, our study fails to demonstrate that G-CSF has the potential to improve pregnancy outcome but has the potential to increase endometrial thickness of the women with thin endometrium in FET cycles.

摘要

这项研究的目的是评估粒细胞集落刺激因子（G-CSF）对接受冷冻融化胚胎移植（FET）子宫内膜（≤7 mm）薄的女性的影响。这项回顾性队列研究包括271名子宫内膜薄的不孕患者。 117例在孕激素给药前接受宫内注射G-CSF的患者被定义为G-CSF组, 而154例拒绝使用G-CSF治疗的患者被定义为对照组。在G-CSF组中, G-CSF灌注后观察到子宫内膜明显更厚（p <.001）。当我们根据是否受孕将G-CSF组分为两个亚组时, 妊娠组的子宫内膜厚度从6.02±0.92 mm增加到6.98±1.20 mm（p <.001）, 未妊娠组从6.21±0.96 mm增加6.87 ± 1.16 mm（p<.001）, 两个亚组之间没有显著差异。 G-CSF组与对照组的着床率, hCG阳性率和临床妊娠率相似。因此, 我们的研究未能证明G-CSF有可能改善妊娠结局, 但有可能增加FET周期中子宫内膜薄的女性的子宫内膜厚度。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Granulocyte colony-stimulating factor
• endometrial thickness
• frozen-thawed embryo transfer
• pregnancy rate

Acknowledgements

We would like to thank the staff at the Fertility Center at Shenzhen Zhongshan Urology Hospital for recruiting patients and helping with samples.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was supported by Basic Research Program of Shenzhen (JCYJ20170307140647669), specific funding from Clinical Medical Research of Chinese Medical Association—Reproductive Medicine Clinical Research and Development Youth Programs (17020300699), Science and Technology Project of Health and Family Planning Commission of Shenzhen Municipality (SZBC2018003), Disciplines Construction and Capacity Improvement Project of Health and Family Planning Commission of Shenzhen Municipality (SZXJ2017004) and Sanming Project of Medicine in Shenzhen (SZSM201502035).