Comparison of Frozen Embryo Transfer Outcomes Between Uterine Infusion of Granulocyte Colony-Stimulating Factor and Growth Hormone Application in Patients With Thin Endometrium: A Retrospective Study

ObjectiveTo investigate the effect of two treatments on the outcome of freeze-thaw embryo transfer for pregnancy assistance in thin endometrium.MethodsA retrospective study was conducted on 66 patients who failed in the first cycle treated in the reproductive medicine center of the Second Hospital of Hebei Medical University from January 2018 to December 2019. Granulocyte colony stimulating factor (G-CSF) was used through cavity infusion in one group (n=25, and growth hormone (GH) was subcutaneously injected in the group (n=41). The clinical data of the two groups were compared, including morphology and thickness of the endometrium, biochemical pregnancy rate, clinical pregnancy rate, implantation rate, miscarriage rate, and live birth rate in each period of the hormone replacement cycle.ResultsThere was no significant difference in age, BMI, AMH, FSH, LH, E2, infertility years, number of transferred embryos, basal endometrium, and thickness of endometrium on the day of P administration before and after treatment (P> 0.05). After treatment, compared to the GH group, the G-CSF group presented higher biochemical pregnancy rate (56% versus 48.8%; P=0.569), clinical pregnancy rate (52% versus 46.3%; P=0.655), implantation rate (34.8% versus 27.5%; P=0.391), and live birth rate (40% versus 31.7%; P=0.493), but the differences were not statistically significant (P > 0.05). On the 5th day of treatment, the endometrial thickness in the G-CSF group was thinner than that in the GH group (4.83 ± 0.85 versus 5.75 ± 1.27; P< 0.05), but it had no correlation with pregnancy outcome (P > 0.05). There was no significant difference in endometrial thickness between the two groups on the 7th, 9th day of treatment and the day of P administration (P > 0.05). On the 5th day of treatment, the proportion of endometrial type A morphology in the GH group was significantly higher than that in the G-CSF group (P < 0.05), while the type B morphology in the G-CSF group was significantly higher than that in the GH group (P< 0.05).ConclusionAlthough G-CSF and GH may not have a role in increasing endometrium, both of them can improve the pregnancy outcomes of patients with thin endometrium in the FET cycle. And the effects of the two treatments were similar.

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Effect of Granulocyte Colony Stimulating Factor (GCSF) on Live Birth Rate in Women With Unexplained Infertility After Intrauterine Insemination: a Randomized Clinical Trial

10.21203/rs.3.rs-130899/v1 ◽

2020 ◽

Author(s):

Shahintaj Aramesh ◽

Maryam Azizi Kutenaee ◽

Fataneh Najafi ◽

Parvin Ghaffari ◽

Seyed Abdolvahab Taghavi

Keyword(s):

Live Birth ◽

Birth Rate ◽

Live Birth Rate ◽

Unexplained Infertility ◽

Clinical Pregnancy ◽

Control Group ◽

Granulocyte Colony Stimulating Factor ◽

Biochemical Pregnancy ◽

Significant Difference ◽

Stimulating Factor

Abstract Background: to evaluate the effect of granulocyte colony stimulating factor (GCSF) on fertility outcomes in women with unexplained infertility after intra uterine insemination (IUI).Methods: The patients with unexplained infertility were divided into two groups: one group was received GCSF in their IUI cycle and the other group had the routine IUI. Both groups were stimulated by letrozole, metformin and monotropin during the cycle. When at least one follicle was greater than 18mm, 5000 IU hCG intramuscularly was administered for ovulation induction and IUI was performed 34-36 hours later. In intervention group, 300 ug GCSF subcutaneously administrated in two days after IUI. The main outcome measures were biochemical pregnancy, clinical pregnancy, abortion rate and live birth rate.Results: There was no significant difference in demographic and clinical characteristics between the control group and the G-CSF group. Also, no statistically significant difference was identified in the biochemical pregnancy rates (16.3% vs 12.2%), clinical pregnancy rates(16.3% vs 8.2%), abortion rates (0 vs 2.04%) and live birth rates (8.2% vs 14.2%) between the control group and the G-CSF group (P=0.56, P=0.21, p=0.55 and p=0.32 respectively). Conclusion: Systemic administration of a single dose of 300 μg GCSF subcutaneously two days after IUI may slightly improve clinical pregnancy rate and live birth rate in patients with unexplained infertility. Nevertheless, our findings do not support routine use of G-CSF in unexplained infertility women with normal endometrial thickness. IRCT registration number: IRCT20160524028038N4.

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Granulocyte Colony-Stimulating Factor Combined With Transcutaneous Electrical Acupoint Stimulation in Treatment of Unresponsive Thin Endometrium in Frozen Embryo Transfer Cycles

Frontiers in Reproductive Health ◽

10.3389/frph.2021.647336 ◽

2021 ◽

Vol 3 ◽

Author(s):

Linjiang Song ◽

Qinxiu Zhang ◽

Shaomi Zhu ◽

Xudong Shan

Keyword(s):

Embryo Transfer ◽

Endometrial Thickness ◽

Embryo Implantation ◽

Implantation Rate ◽

Granulocyte Colony Stimulating Factor ◽

Thin Endometrium ◽

Treatment Groups ◽

Stimulating Factor ◽

Embryo Implantation Rate ◽

Acupoint Stimulation

Objective: This trial was designed to assess the treatment effects of granulocyte colony-stimulating factor (G-CSF) and transcutaneous electrical acupoint stimulation (TEAS) on thin endometrium in frozen-thawed embryo transfer (FET) cycles.Methods: Ninety-nine patients with previous cancellations of embryo transfer were included, 56 of whom were prospectively treated with intrauterine perfusion of G-CSF in subsequent FET cycles. The selected patients were randomized into the G-CSF perfusion only group and the G-CSF perfusion combined with TEAS group. The other 43 patients were retrospectively included as controls.Results: Compared to previous cycles, endometrial thickness was statistically significantly increased in the two treatment groups (5.97 ± 0.60, 7.52 ± 0.56, 6.14 ± 0.52, and 7.66 ± 0.44; P = 0.00 and 0.00, respectively). The increases in endometrial thickness suggested that no statistically significant difference was found between the two treatment groups. The G-CSF with TEAS group suggested a higher embryo implantation rate than the G-CSF perfusion only and control groups (33.33 and 29.1% and 33.33 and 17.39%; P = 0.412 and 0.091, respectively). The G-CSF combined with TEAS group demonstrated nominally higher clinical and ongoing pregnancy rates than the G-CSF perfusion-only group and controls, though, the difference was not statistically significant.Conclusion: G-CSF has a potential role in improving endometrium thickness in patients with thin unresponsive endometrium in FET treatment cycles. In addition, when combined with TEAS, G-CSF perfusion treatment also improves the embryo implantation rate; however, randomized controlled trials are highly demanded to provide high-grade evidence regarding clinical pregnancy rate after G-CSF perfusion treatment.

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Caesarean section defects may affect pregnancy outcomes after in vitro fertilization-embryo transfer: a retrospective study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03955-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Junrong Diao ◽

Ge Gao ◽

Yunshan Zhang ◽

Xinyan Wang ◽

Yinfeng Zhang ◽

...

Keyword(s):

Caesarean Section ◽

Pregnancy Rate ◽

Live Birth ◽

Birth Rate ◽

Implantation Rate ◽

Live Birth Rate ◽

Vitro Fertilization ◽

Biochemical Pregnancy ◽

History Of

Abstract Background Caesarean section rates are rising worldwide. One adverse effect of caesarean section reported in some studies is an increased risk of subfertility. Only a few studies have assessed the relationship between the previous mode of delivery and in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) reproductive outcomes. In this study, we primarily investigated the impact of a history of caesarean section with or without defects on IVF/ICSI-ET outcomes compared to a vaginal delivery history. Methods This retrospective study included 834 women who had a IVF or ICSI treatment at our centre between 2015 and 2019 with a delivery history. In total, 401 women with a previous vaginal delivery (VD) were assigned to the VD group, and 433 women with a history of delivery by caesarean section were included, among whom 359 had a caesarean scar (CS) without a defect and were assigned to the CS group and 74 had a caesarean section defect (CSD) and were assigned to the CSD group. Baseline characteristics of the three groups were compared and analysed. Binary logistic regression analyses were performed to explore the association between clinical outcomes and different delivery modes. Results There were no significant differences in the live birth rate, biochemical pregnancy rate, clinical pregnancy rate, mean implantation rate or abnormal pregnancy rate between the CS and VD groups However, the live birth rate and mean implantation rate in the CSD group were significantly lower than those in the VD group (21.6 vs 36.4%, adjusted OR 0.50 [0.27–0.9]; 0.25 ± 0.39 vs 0.35 ± 0.41, adjusted OR 0.90 [0.81–0.99]). Among women aged ≤ 35 years, the subgroup analyses showed that the live birth rate, biochemical pregnancy rate, clinical pregnancy rate, and mean implantation rate in the CSD group were all significantly lower than those in the VD group (21.4 vs 45.8%, adjusted OR 0.35[0.15 ~ 0.85]; 38.1 vs 59.8%, adjusted OR 0.52[0.24–0.82]; 31.0 vs 55.6%, adjusted OR 0.43[0.19–0.92]; 0.27 ± 0.43 vs 0.43 ± 0.43, adjusted OR 0.85[0.43 ± 0.43]). For women older than 35 years, there was no statistically significant difference in any pregnancy outcome among the three groups. Conclusions This study suggested that the existence of a CS without a defect does not decrease the live birth rate after IVF or ICSI compared with a previous VD. However, the presence of a CSD in women, especially young women (age ≤ 35 years), significantly impaired the chances of subsequent pregnancy.

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The efficacy of tamoxifen in the treatment of thin endometrium in frozen-thawed embryo transfer cycle

10.21203/rs.2.21455/v1 ◽

2020 ◽

Author(s):

Jingjuan Ji ◽

Lihua Luo ◽

Lingli Huang

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Endometrial Thickness ◽

Hormone Replacement ◽

Implantation Rate ◽

Live Birth Rate ◽

Tamoxifen Treatment ◽

Induction Agent ◽

Ongoing Pregnancy Rate ◽

Thin Endometrium

Abstract Background: Thin endometrium is known to adversely affect reproductive performance. There is no agreement about a consensus treatment on thin endometrium. Tamoxifen(TAM) has a positive effect on endometrium when used as ovulation induction agent. Little information is available regarding its use in patients with thin endometrium during frozen-thaw embryo transfer (FET) cycles. This study was designed to evaluate the effectiveness of TAM on women with thin endometrium in frozen-thaw embryo transfer cycles. Methods: A total of 345 thin endometrium women were retrospectively analyzed during their FET cycles. Among them 190 received TAM protocol (TAM 20 mg per day for 5 days) and 155 hormone replacement therapy (HRT) protocol (estradiol valerate 6 mg/d for 14 to 21days). Endometrial thickness and pregnancy outcome were compared between the two groups. Result(s): The endometrial thickness in TAM group was significantly higher compared with HRT group. The clinical pregnancy rate, implantation rate, ongoing pregnancy rate and live birth rate were significantly higher in TAM group than HRT group. Conclusion(s): In patients of recurrent thin endometrium, tamoxifen treatment in endometrium preparation may be a successful alternative approach

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Evaluation of Granulocyte Colony-Stimulating Factor Effects on Treatment-Resistant Thin Endometrium in Women UndergoingIn VitroFertilization

BioMed Research International ◽

10.1155/2014/913235 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 38

Author(s):

Michał Kunicki ◽

Krzysztof Łukaszuk ◽

Izabela Woclawek-Potocka ◽

Joanna Liss ◽

Patrycja Kulwikowska ◽

...

Keyword(s):

Pregnancy Rate ◽

Endometrial Thickness ◽

Clinical Pregnancy ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Treatment Resistant ◽

Thin Endometrium ◽

Before And After ◽

Stimulating Factor

The aim of the study was to assess the granulocyte colony-stimulating factor (G-CSF) effects on unresponsive thin (<7 mm) endometrium in women undergoingin vitrofertilization (IVF). We included thirty-seven subjects who had thin unresponsive endometrium on the day of triggering ovulation. These patients also failed to achieve an adequate endometrial thickness in at least one of their previous IVF cycles. In all the subjects at the time of infusion of G-CSF, endometrial thickness was 6,74 ± 1,75 mm, and, after infusion, it increased significantly to 8,42 ± 1,73 mm. When we divided the group into two subgroups according to whether the examined women conceived, we showed that the endometrium expanded significantly from 6,86 ± 1,65 to 8,80 ± 1,14 mm in the first group (who conceived) and from 6,71 ± 1,80 to 8,33 ± 1,85 mm in the second, respectively. There were no significant differences between the two subgroups in respect to the endometrial thickness both before and after G-CSF infusion. The clinical pregnancy rate was 18,9%. We concluded that the infusion of G-CSF leads to the improvement of endometrium thickness after 72 hours.

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P–391 Role of subcutaneous granulocyte colony-stimulating factor infusion in thin endometrium

Human Reproduction ◽

10.1093/humrep/deab130.390 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

K Banerjee ◽

B Singla

Keyword(s):

Pregnancy Rate ◽

Clinical Pregnancy ◽

P Value ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Thin Endometrium ◽

Group 2 ◽

Stimulating Factor ◽

Group 1

Abstract Study question To assess the role of subcutaneous granulocyte colony-stimulating factor (G-CSF) in thin endometrium cases. Summary answer G CSF has beneficial role to improve the endometrium thickness in thin endometrium. What is known already Endometrium is very important for embryo implantation and the endometrial thickness is the marker of receptivity of the endometrium. Study design, size, duration Study design - Retrospective analysis Size - 88 infertile females with thin endometrium (< 7 mm) in the age group of 23 to 40 years Duration - one year. Participants/materials, setting, methods In the group 1 of 44 females, subcutaneous infusion of G CSF (300 mcg/ml) was added along with other supplements and if lining was not more than 7 mm in 72 hours, then second infusion was given. In the group 2 of 44 females, only estradiol valerate and sildenafil were given.The efficacy of G CSF was evaluated by assessing the endometrium thickness before embryo transfer, pregnancy rates and clinical pregnancy rates. Main results and the role of chance There was no difference between the two groups regarding demographic variables, egg reserve, sperm parameters, number of embryos transferred and embryo quality. . The pregnancy rate was 60% (24 out of 40 cases) in the group 1 that was significantly higher than in-group 2 that was 31% (9 out of 29 cases) with p value < 0.0001. The clinical pregnancy rate was also significantly higher in-group 1 (55%) as compared to group 2 (24%) with p value < 0.0001. Limitations, reasons for caution Further larger cohort studies are required to explore the subcutaneous role of G CSF in thin endometrium. Wider implications of the findings: Granulocyte colony-stimulating factor has beneficial role to improve the endometrium thickness in thin endometrium. In most of previous studies, the intrauterine infusion of G CSF was given to improve the uterine lining. This is one of the few studies done that showed subcutaneous role of G CSF in thin endometrium. Trial registration number Not applicable

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The incidence rate of unresponsive thin endometrium in frozen embryo transfer cycles: A case-series of therapy with granulocyte colony stimulating factor

International Journal of Reproductive BioMedicine ◽

10.18502/ijrm.v17i12.5797 ◽

2019 ◽

Cited By ~ 1

Author(s):

Shokouhosadat Miralaei ◽

Mahnaz Ashrafi ◽

Arezoo Arabipoor ◽

Zahra Zolfaghari ◽

Saeideh Taghvaei

Keyword(s):

Embryo Transfer ◽

Endometrial Thickness ◽

Case Series ◽

Frozen Embryo Transfer ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Cross Sectional ◽

Thin Endometrium ◽

Stimulating Factor

Background: Treatment-resistant thin endometrium (TTE) during in-vitro fertilization is a relatively uncommon and challenging problem. Objective: The primary aim of the study was to assess the TTE rate during frozen embryo transfer (FET) cycles and the secondary aim was to evaluate the effect of intrauterine instillation of granulocyte colony stimulating factor (G-CSF) in these cases. Materials and Methods: In this cross-sectional study, all of the women who underwent FET cycles with hormonal endometrial preparation in Royan Institute from June 2015 to March 2018 were evaluated and all of the cases with TTE diagnosis (endometrial thickness < 7 mm after using high doses of estradiol) were included. In the eligible cases, 300 μgr of G-CSF was infused intrauterine. If the endometrium had not reached at least a 7-mm, a second infusion was prescribed within 48 hr later. Results: During the study, 8,363 of FET cycles were evaluated and a total of 30 infertile patients (0.35%) with TTE diagnosis were detected. Finally, 20 eligible patients were included. The changes of endometrial thickness after G-CSF therapy were significant (p< 0.001); however, the endometrial thickness did not reach 7 mm in nine patients (45%) and the embryo transfer was canceled. Conclusion: It was found that the rate of TTE during the FET cycle is very low and intrauterine perfusion of G-CSF has a potential effect to increase the endometrial thickness in these patients; however, the rate of cancellation was still high and poor pregnancy outcomes were observed. Key words: Granulocyte colony-stimulating factor, Cryopreservation, Embryo transfer, Endometrial diseases.

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Live Birth Rate of Fresh Embryo Transfer with GnRH Agonist Long Protocol is Higher Than Frozen Embryo Transfer

10.21203/rs.3.rs-70853/v1 ◽

2020 ◽

Author(s):

Xiaoyan Ding ◽

Jingwei Yang ◽

Lan Li ◽

Na Yang ◽

Ling Lan ◽

...

Keyword(s):

Pregnancy Rate ◽

Embryo Transfer ◽

Live Birth ◽

Pregnancy Loss ◽

Birth Rate ◽

Implantation Rate ◽

Live Birth Rate ◽

Clinical Pregnancy ◽

Fresh Embryo Transfer ◽

Long Protocol

Abstract Background: Along with progress in embryo cryopreservation, especially in vitrification has made freeze all strategy more acceptable. Some studies found comparable or higher live birth rate with frozen embryo transfer (FET) than with fresh embryo transfer（ET）in gonadotropin releasing hormone antagonist (GnRH-ant) protocol. But there were no reports about live birth rate differences between fresh ET and FET with gonadotropin releasing hormone agonist (GnRH-a) long protocol. The aim of this study is to analyze whether patients benefit from freeze all strategy in GnRH-a protocol from real-world data.Methods: This is a retrospective cohort study, in which women undergoing fresh ET or FET with GnRH-a long protocol at Chongqing Reproductive and Genetics Institute from January 2016 to December 2018 were evaluated. The primary outcome was live birth rate. The secondary outcomes were implantation rate, clinical pregnancy rate, pregnancy loss and ectopic pregnancy rate.Results: A total of 7,814 patients met inclusion criteria, implementing 5,216 fresh ET cycles and 2,598 FET cycles, respectively. The demographic characteristics of the patients were significantly different between two groups, except BMI. After controlling for a broad range of potential confounders (including age, infertility duration, BMI, AMH, no. of oocytes retrieved and no. of available embryos), multivariate logistic regression analysis demonstrated that there was no significant difference in terms of clinical pregnancy rate, ectopic pregnancy rate and pregnancy loss rate between two groups (all P>0.05). However, the implantation rate and live birth rate of fresh ET group were significantly higher than FET group (P<0.001 and P=0.012, respectively).Conclusion: Compared to FET, fresh ET following GnRH-a long protocol could lead to higher implantation rate and live birth rate in infertile patients underwent in vitro fertilization (IVF). The freeze all strategy should be individualized and made with caution especially with GnRH-a long protocol.

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Influence of surgical evacuation on pregnancy outcomes of subsequent embryo transfer cycle following miscarriage in an initial IVF cycle: a retrospective cohort study

BMC Pregnancy and Childbirth ◽

10.1186/s12884-019-2543-9 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Junan Meng ◽

Mengchen Zhu ◽

Wenjuan Shen ◽

Xiaomin Huang ◽

Haixiang Sun ◽

...

Keyword(s):

Embryo Transfer ◽

Live Birth ◽

Pregnancy Outcomes ◽

Birth Rate ◽

Endometrial Thickness ◽

Live Birth Rate ◽

First Trimester ◽

Miscarriage Rate ◽

Significant Difference ◽

Surgical Evacuation

Abstract Background It is still uncertain whether surgical evacuation adversely affects subsequent embryo transfer. The present study aims to assess the influence of surgical evacuation on the pregnancy outcomes of subsequent embryo transfer cycle following first trimester miscarriage in an initial in vitro fertilization and embryo transfer (IVF-ET) cycle. Methods A total of 645 patients who underwent their first trimester miscarriage in an initial IVF cycle between January 2013 and May 2016 in Nanjing Drum Tower Hospital were enrolled. Surgical evacuation was performed when the products of conception were retained more than 8 h after medical evacuation. Characteristics and pregnancy outcomes were compared between surgical evacuation patients and no surgical evacuation patients. The pregnancy outcomes following surgical evacuation were further compared between patients with ≥ 8 mm or < 8 mm endometrial thickness (EMT), and with the different EMT changes. Results The EMT in the subsequent embryo transfer cycle of surgical evacuation group was much thinner when compared with that in the no surgical evacuation group (9.0 ± 1.6 mm vs. 9.4 ± 1.9 mm, P = 0.01). There was no significant difference in implantation rate, clinical pregnancy rate, live birth rate or miscarriage rate between surgical evacuation group and no surgical evacuation group (P > 0.05). The live birth rate was higher in EMT ≥ 8 mm group when compared to < 8 mm group in surgical evacuation patients (43.0% vs. 17.4%, P < 0.05). Conclusions There was no significant difference in the pregnancy outcomes of subsequent embryo transfer cycle between surgical evacuation patients and no surgical evacuation patients. Surgical evacuation led to the decrease of EMT, especially when the EMT < 8 mm was association with a lower live birth rate.

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Determining Diagnostic Criteria of Unexplained Recurrent Implantation Failure: A Retrospective Study of Two vs Three or More Implantation Failure

Frontiers in Endocrinology ◽

10.3389/fendo.2021.619437 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yingying Sun ◽

Yile Zhang ◽

Xueshan Ma ◽

Weitong Jia ◽

Yingchun Su

Keyword(s):

Pregnancy Rate ◽

Diagnostic Criteria ◽

Live Birth ◽

Birth Rate ◽

Negative Impact ◽

Live Birth Rate ◽

Implantation Failure ◽

Recurrent Implantation Failure ◽

Significant Difference ◽

Definition Of

BackgroundThe definition of recurrent implantation failure (RIF) differs clinically, one of the most controversial diagnostic criteria is the number of failed treatment cycles. We tried to investigate whether the two implantation failure could be included in the diagnostic criteria of RIF.MethodsA retrospective analysis of the clinical data of patients (N=1518) aged under 40 years with two or more implantation failure, recruited from the Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University from January 2016 to June 2019.ResultsAfter adjusting for confounding factors by using binary logistic regression, the results showed that partial general information and: distribution of associated factors were significant differences such as maternal age (aOR=1.054, P=0.001), type of cycle (aOR=2.040, P<0.001), stage of embryos development (aOR=0.287, P<0.001), number of embryos transferred (aOR=0.184, P<0.001), female factor (tubal pathology) (aOR=0.432, P=0.031) and male factor (aOR=1.734, P=0.002) between the groups with two and three or more unexplained implantation failure. And further explored whether these differential factors had a significant negative impact on pregnancy outcome, the results showed that: for patients who had three unexplained implantation failure, in the fourth cycle of ET, the live birth rate decreased significantly with age (aOR=0.921, P<0.001), and the live birth rate of blastocyst transfer was significantly higher than that of cleavage embryo transfer (aOR=1.826, P=0.007). At their first assisted pregnancy treatment after the diagnosis of RIF according to these two different definitions, there were no significant difference in the biochemical pregnancy rate, clinical pregnancy rate, ectopic pregnancy rate and abortion rate (P>0.05), but the live birth rate (35.64% vs 42.95%, P=0.004) was significantly different. According to the definition of ‘two or more failed treatment cycles’, the live birth rate of the first ET treatment after RIF diagnosis was significantly lower than that of patients according to the definition of ‘three or more failed treatment cycles’.ConclusionFor patients with unexplained recurrent implantation failure, two implantation failure cannot be included in the diagnostic criteria of RIF. This study supports the generally accepted definition of three or more failed treatment cycles for RIF.

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