Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2021; 9(30): 9038-9049
Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9038
Effect of intrauterine perfusion of granular leukocyte-colony stimulating factor on the outcome of frozen embryo transfer
Ying-Chun Zhu, Yan-Xin Sun, Xiao-Yue Shen, Yue Jiang, Jing-Yu Liu
Ying-Chun Zhu, Yan-Xin Sun, Xiao-Yue Shen, Yue Jiang, Jing-Yu Liu, Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
Author contributions: Jiang Y and Liu JY contributed to the project development and manuscript editing; Shen XY and Zhu YC contributed to the experiments; Shen XY and Zhu YC contributed to the data collection and manuscript writing; Sun YX and Zhu YC contributed to the data management and data analysis.
Supported by Chinese Medical Association, No. 17020450714; and Medical Science and Technology Development Foundation, Nanjing Department of Health, No. YKK18090.
Institutional review board statement: This study was approved by the ethics committee of the Affiliated Drum Tower Hospital of Nanjing University Medical School (Approval No. 2020-064-01).
Informed consent statement: Patients were not required to provide informed consent because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare that there are no any conflicts of interest.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing-Yu Liu, MM, MS, Doctor, Reproductive Medicine Center, The Affiliated Drum Tower Hospital of Nanjing University Medical School, No. 321 Zhongshan Road, Nanjing, Nanjing 210008, China. lianjing1216@126.com
Received: March 12, 2021
Peer-review started: March 12, 2021
First decision: July 26, 2021
Revised: August 4, 2021
Accepted: September 14, 2021
Article in press: September 14, 2021
Published online: October 26, 2021
Abstract
BACKGROUND

Treatment of thin endometrium with granular leukocyte-colony stimulating factor (G-CSF) remains controversial.

AIM

To investigate the effect of G-CSF on the outcome of frozen embryo transfer in patients with thin endometrium.

METHODS

A retrospective propensity score matching (PSM) study was performed to assess patients administered frozen embryo transfer at the Reproductive Medicine Center of the Affiliated Drum Tower Hospital of Nanjing University Medical School, in 2012-2018. The patients were divided into G-CSF intrauterine perfusion (G-CSF) and non-G-CSF groups, and clinical pregnancy, implantation, ectopic pregnancy, and early abortion rates between the two groups were compared.

RESULTS

Before PSM, 372 cycles were enrolled, including 242 and 130 cycles in the G-CSF and non-G-CSF groups, respectively. Age (34.23 ± 5.76 vs 32.99 ± 5.59 years; P = 0.047) and the blastula/cleavage stage embryo ratio (0.68 vs 0.37; P = 0.011) were significantly elevated in the G-CSF group compared with the non-G-CSF group; however, clinical pregnancy (46.28% vs 51.54%; P = 0.371) and embryo implantation (35.21% vs 35.65%; P = 0.910) rates were similar in both groups. After PSM by age and blastula/cleavage stage embryo ratio, 244 cycles were included (122 cases each in the G-CSF and non-G-CSF groups). The clinical pregnancy (50.82 % vs 48.36%; P = 0.701) and embryo implantation (37.38% vs 34.11%; P = 0.480) remained similar in both groups.

CONCLUSION

Intrauterine infusion of G-CSF does not improve the clinical outcome of frozen embryo transfer in patients with thin endometrium.

Keywords: Thin endometrium, Granular leukocyte-colony stimulating factor, Intrauterine perfusion, Frozen embryo transfer

Core Tip: Granular leukocyte-colony stimulating factor (G-CSF) administration for the treatment of thin endometrium remains controversial. A retrospective study of patients with thin endometrium who underwent frozen embryo transfer (FET) at the Reproductive Medicine Center of the Affiliated Drum Tower Hospital of Nanjing University Medical School, from January 1, 2012 to December 31, 2018, was performed. This study suggested that G-CSF intrauterine infusion does not increase clinical pregnancy and embryo implantation rates after FET in patients with thin endometrium. Early abortion may be somewhat decreased by G-CSF administration.