Effect of Intrauterine Perfusion of Granulocyte Colony-Stimulating Factor on Endometrium and Blood Flow Parameters in Patients With Thin Endometrium: A Prospective Controlled Clinical Trial

XU Shaorong, MA Qianhong, ZHANG Yao, AN Yinhua, HE Wei, MA Ying, LI Junlin, LI Dan, LU Wei, MA Qinqin, YONG Jiajia, LA

Abstract

To investigate the effects of intrauterine perfusion with granulocyte colony-stimulating factor (G-CSF) on the endometrial thickness, volume, and blood flow parameters of patients with thin endometrium and their clinical outcomes.
Methods  We designed a prospective non-randomized synchronous controlled trial and recruited patients with thin endometrium who underwent frozen-thawed embryo transfer (FET) at Mianyang Central Hospital between September 1, 2021 and September 1, 2023. They were divided into two groups, an experimental group of patients who received the experimental treatment of intrauterine perfusion with G-CSF and a control group of patients who did not receive the experimental treatment. The general data and the clinical outcomes of the two groups were analyzed and compared. The endometrial thickness, volume and blood flow parameters of patients in the experimental group before and after intrauterine perfusion with G-CSF were analyzed.
Results  The clinical data of 83 patients were included in the study. The experimental group included 51 cases, while the control group included 31 cases. There were no significant differences in the baseline data between the two groups. The clinical pregnancy rate of the experimental group (56.86%) was higher than that of the control group (50.00%) and the rate of spontaneous abortion in the experimental group (27.59%) was lower than that in the control group (37.50%), but the differences were not statistically significant (P>0.05). In the experimental group, the postperfusion endometrial thickness ([0.67±0.1] cm) was greater than the preperfusion endometrial thickness ([0.59±0.09] cm), the postperfusion ([1.84±0.81] cm3) was greater than the preperfusion endometrial volume ([1.54±0.69] cm3), and the postperfusion vascularization flow index (VFI) (1.97±2.82) was greater than the preperfusion VFI (0.99±1.04), with all the differences being statistically significant (P<0.05).
Conclusion  Intrauterine perfusion with G-CSF can enhance the endometrial thickness, volume, and some blood flow parameters in patients with thin endometrium.

 

Keywords: Intrauterine perfusion, Granulocyte colony-stimulating factor, Thin endometrium, Endometrial receptivity

 

Full Text:

PDF


References


AMIR W, MICHA B, ARIAL H, et al. Predicting factors for endometrial thickness during treatment with assisted reproductive technology. Fertil Steril, 2007, 87(4): 799–804. doi: 10.1016/j.fertnstert.2006.11.002.

MOMENI M. A meta-analysis of the relationship between endometrial thickness and outcome of in vitro fertilization cycles. J Hum Reprod Sci, 2011, 12(4): 130–137. doi: 10.4103/0974-1208.92287.

ZHANG X, CHEN C H, CONFINO E, et al. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization embryo transfer. Fertil Steril, 2005, 83(2): 336–340. doi: 10.1016/j.fertnstert.2004.09.020.

SINGH N, BAHADUR A, MITTAL S, et a1. Predictive value of endometrial thickness, pattern and subendometfial blood flows on the day of hCG by 2D doppler in in vitro fertilization cycles: a prospective clinical study from atertiary care unit. J Hum Reprod Sci, 2011, 4(1): 29–33. doi: 10.4103/0974-1208.82357.

MARTINS R S, OLIANI A H, OLIANI D V, et al. Subendometrial resistence and pulsatility index assessment of endometrial receptivity in assisted reproductive technology cycles. Reprod Biol Endocrinol, 2019, 17(1): 1–7. doi: 10.1186/s12958-018-0446-7.

GLEIEHER N, VLDALI A, BARAD D H. Successful treatment of unresponsive thin endometrium. Fertil Steril , 2011, 95(6): 2123.e13–2123.e17. doi: 10.1016/j.fertnstert.2011.01.143.

GLEICHER N, KIM A, MICHAELI T, et a1. A pilot cohort study of granulocyte colony-stimulating factor in the treatment of unresponsive thin endometrium resistant to standard therapies. Hum Reprod, 2013, 28(1): 172–177. doi: 10.1093/humrep/des370.

BAMD D H, YU Y, KUSHNIR V A, et a1. A randomized clinical trim of endometrial perfusion with granulocyte colony-stimulating factor in in vitro fertilization cycles: impact on endometrial thickness and clinical pregnancy rates. Fertil Steril, 2014, 101(3): 710–715. doi: 10.1016/j. fertnstert.2013.12.016.

ROBERT C A, ABBAS M K, ZAIDI A R Z, et al. Mediator in the embryo-endometrium cross-talk: granulocyte colony-stimulating factor in infertility. Cureus, 2019, 11(8):e5390. doi: 10.7759/cureus.5390.

ZHANG Y, CHEN X, CHEN S, et al. Intrauterine administration of G-CSF for promoting endometrial growth after hysteroscopic adhesiolysis: a randomized controlled trial. Hum Reprod, 2022, 37(4): 725–733. doi: 10. 1093/humrep/deac023.

RAPOSO C G, MARÍN Á P, BARÓN M G. Colony-stimulating factors: clinical evidence for treatment and prophylaxis of chemotherapy-induced febrile neutropenia. Clin Transl Oncol, 2006, 8: 729–734. doi: 10.1007/s12094-006-0119-4.

WÜRFEL W. Approaches to a better implantation. J Assist Reprod Genet, 2000, 17(8): 473.

SCARPELLINI F, SBRACIA M. Use of granulocyte colony-stimulating factor for the treatment of unexplained recurrent miscarriage: a randomised controlled trial. Hum Reprod, 2009, 24(11): 2703–2708. doi: 10.1093/humrep/dep240.

XIE Y, ZHANG T, TIAN Z, et al. Efficacy of intrauterine perfusion of granulocyte colony-stimulating factor (G-CSF) for Infertile women with thin endometrium: a systematic review and meta-analysis. Am J Reprod Immunol, 2017, 78(2): e12701. doi: 10.1111/aji.12701.

FURMENTO V A, MARINO J, BLANK V C, et al. Granulocyte colony-stimulating factor (G-CSF) upregulates β1 integrin and increases migration of human trophoblast Swan 71 cells via PI3K and MAPK activation. Exp Cell Res, 2016, 342(2): 125–134. doi: 10.1016/j.yexcr.2016. 03.005.

FURMENTO V A, MARINO J, BLANK V C, et al. The granulocyte colony-stimulating factor (G-CSF) up regulates metalloproteinase-2 and VEGF through PI3K/Akt and Erk1/2 activation in human trophoblast Swan 71 cells. Placenta, 2014, 35(11): 937–946. doi: 10.1016/j.placenta. 2014.09.003.

AMOOEE S, SHOMALI Z, NAMAZI N, et al. Is there any role for granulocyte colony stimulating factor in improvement of implantation in intrauterine insemination? A prospective double-blind randomized control trial. Int J Fertil Steril, 2022, 16(4): 281–285. doi: 10.22074/ijfs. 2021.537125.1171.

ZHANG L, XU W H, FU X H, et al. Therapeutic role of granulocyte colony-stimulating factor (G-CSF) for infertile women under in vitro fertilization and embryo transfer (IVF-ET) treatment: a meta-analysis. Arch Gynecol Obstet, 2018, 298: 861–871. doi: 10.1007/s00404-018-4892-4.[19]


Refbacks

  • There are currently no refbacks.