Effect of Intra Uterine Granulocyte Colony Stimulating Factor vs. Human Chorionic Gonadotropin at Ovum Pick Up Day on Pregnancy Rate in IVF/ICSI Cases With Recurrent Implantation Failure

• Published in: JBRA assisted reproduction Vol. 26; no. 2; pp. 274 - 279
• Main Authors: Torky, Haitham, El-Desouky, El-Sayed, El-Baz, Ashraf, Aly, Rania, El-Taher, Osama, Shata, Atef, Hussein, Ahmed, Marie, Heba, Deif, Osama, Eldemery, Ahmed, Abo-Louz, Ashraf
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Reprodução Humana (Brazilian Society of Assisted Reproduction) 2022; Brazilian Society of Assisted Reproduction
• Subjects: Abortion, Spontaneous; Catheters; Chorionic Gonadotropin; Confidence intervals; Embryo Transfer; Embryos; Female; Fertilization in Vitro; Granulocyte Colony-Stimulating Factor - therapeutic use; Granulocytes; Growth factors; Humans; Miscarriage; Original; Ovaries; Pharmaceuticals; Pregnancy; Pregnancy Rate; Prospective Studies; Saline Solution; Sperm Injections, Intracytoplasmic; Ultrasonic imaging; Vagina; Variance analysis; United Kingdom > UK; Switzerland; ovum pick-up; G-CSF; hCG; intrauterine injection; clinical pregnancy
• ISSN: 1518-0557; 1517-5693; 1518-0557
• DOI: 10.5935/1518-0557.20210056

Recurrent implantation failure is defined as failure to achieve clinical pregnancy after the transfer of four or more good-quality embryos in a minimum of three fresh or frozen cycles in a woman aged less than 40 years. The objective is to compare between the effect of intrauterine G-CSF, hCG, and saline solution injection (as placebo) at the day of ovum pick-up on clinical pregnancy, chemical pregnancy, implantation, and miscarriage rates in patients with recurrent implantation failure undergoing IVF/ICSI. This prospective, double blind, parallel, randomized controlled trial included 150 patients equally divided into 3 groups, each containing 50 individuals. Subjects in Group 1 received intrauterine injections of G-CSF; Group 2: received intrauterine injections of 500 IU of hCG; and Group 3 received intrauterine injections of saline solution as placebo. The primary outcome measure is clinical pregnancy rate. Secondary outcomes are biochemical pregnancy, implantation, and miscarriage rates. Clinical pregnancy, biochemical pregnancy, and implantation rates were highest in the group given G-CSF and lowest in the group administered saline solution; miscarriage rates were not significantly different between the groups. Intrauterine administration of G-CSF at a dose of 100 µg/1.0 cc at the time of ovum pick-up is associated with better clinical pregnancy, chemical pregnancy, and implantation rates as compared with intrauterine saline solution administration. Further studies are needed to determine the optimum timing of intrauterine administration of G-CSF that achieves the best results, and longer follow-up is needed to determine take-home baby percentages.