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

2021 ◽  
Vol 3 ◽  
Author(s):  
Linjiang Song ◽  
Qinxiu Zhang ◽  
Shaomi Zhu ◽  
Xudong Shan

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.

Author(s):  
Shokouhosadat Miralaei ◽  
Mahnaz Ashrafi ◽  
Arezoo Arabipoor ◽  
Zahra Zolfaghari ◽  
Saeideh Taghvaei

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.


2021 ◽  
Vol 12 ◽  
Author(s):  
Lei Jiang ◽  
Xin Xu ◽  
Ziyu Cao ◽  
Ni Yang ◽  
Shaoqing Wang ◽  
...  

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&gt; 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 &gt; 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&lt; 0.05), but it had no correlation with pregnancy outcome (P &gt; 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 &gt; 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 &lt; 0.05), while the type B morphology in the G-CSF group was significantly higher than that in the GH group (P&lt; 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.


2018 ◽  
Vol 6 (2) ◽  
pp. 31-36
Author(s):  
Marzie Farimani ◽  
Narges Mehrabi ◽  
Azar Pirdehghan ◽  
Maryam Bahmanzadeh

Background: Granulocyte-colony stimulating factor (G-CSF) is an innovative therapy in reproductive medicine. Although its mechanisms of action have remained unknown, G-CSF seems to be effective in the case of recurrent abortion or implantation failure and thin endometrium. Objectives: This study was conducted to investigate whether subcutaneous administration of G-CSF has any effect on pregnancy outcome after assisted reproductive technology (ART). Methods: Fifty women with male infertility factors undergoing ART treatment were enrolled and stimulated with the standard long protocol. The G-CSF group of women received one dose of subcutaneous G-CSF (Filgrastim, 300 µg/1 mL) on the day of embryo transfer and again two days later while the placebo group received normal saline. Results: Seventeen patients had a positive β-human chorionic gonadotropin concentration after embryo transfer (8 and 9 in G-CSF and placebo groups, respectively) although the difference was not statistically significant. In addition, spontaneous abortion occurred in three patients (1 patient in the G-CSF group vs. 2 patients in the placebo group). Conclusion: Overall, although G-CSF failed to affect the endometrial thickness, as well as implantation, or clinical pregnancy rates, a lower prevalence of abortion in G-CSF group may be due to the positive effect of G-CSF administration on the endometrium as compared to the placebo group.


2020 ◽  
Vol 4_2020 ◽  
pp. 90-96
Author(s):  
Dzhincharadze L.G. Dzhincharadze ◽  
Abubakirov A.N. Abubakirov ◽  
Mishieva N.G. Mishieva ◽  
Fedorova T.A. Fedorova T ◽  
Bakuridze E.M. Bakuridze ◽  
...  

2020 ◽  
Author(s):  
Jingjuan Ji ◽  
Lihua Luo ◽  
Lingli Huang

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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