Abstract:

Objective: To retrospectively analyze the effect of intrauterine perfusion of granulocyte colony-stimulating factor (G-CSF) on the outcome of frozen-thawed embryo transfer (FET) in patients with thin endometrium.Methods: From January 2018 to February 2020, patients with thin endometrium who were scheduled to undergo FET treatment in Hebei Research Institute for Family Planning and Hebei Reproductive Hospital were selected. 64 patients who met the inclusion criteria were treated with intrauterine perfusion of G-CSF. Endometrial thickness, morphology, endometrial blood flow, uterine artery blood flow parameters, and cancellation rate, clinical pregnancy rate and implantation rate in the post-/pre-perfusion cycle and the last cycle were compared with those in the previous hormone replacement therapy (HRT) cycle.Results: There was no difference in the endometrial thickness after intrauterine infusion of G-CSF between the before perfusion and the last cycles (P<0.05). The differences in the uterine PI value, RI value and S/D ratio after intrauterine infusion of G-CSF were not significant between the before perfusion and the last cycles (all P>0.05). The proportion of type A morphological endometrium after intrauterine perfusion was 25.0% (16/64), lower than that in the before perfusion [35.90% (23/64)] and the last cycles [34.4% (22/64)], although the difference was not statistically significant (P>0.05). The proportion of endometrium with type Ⅱ blood flow after intrauterine perfusion [75.00% (48/64)] was higher than that in the before perfusion [26.56% (17/64)] and the last cycles [18.75% (12/64)], and the difference was statistically significant (P<0.05). The abolition rate of perfusion cycle was lower than that of the last cycle (20.3% vs. 37.5%), and the clinical pregnancy rate (60.8% vs. 40.0%) and implantation rate (38.5% vs. 24.4%) were increased (both P<0.05).Conclusions: Intrauterine infusion of G-CSF can improve the endometrial thickness of patients with thin endometrium, reduce the cycle cancellation rate, and improve the pregnancy rate and implantation rate.

Key words: Granulocyte colony-stimulating factor, Embryo transfer, Endometrium, Pregnancy outcome, Frozen embryo transfer