Granulocyte colony-stimulating factor in repeated IVF failure, a randomized trial.

Area of Science:

• Reproductive Endocrinology and Infertility
• Clinical Trials in Assisted Reproductive Technologies

Background:

• Granulocyte colony-stimulating factor (GCSF) plays a role in embryo implantation and pregnancy maintenance.
• Previous studies suggested potential benefits of local intrauterine GCSF infusion in IVF.
• Efficacy of systemic GCSF for recurrent IVF failure requires further investigation.

Purpose of the Study:

• To evaluate the efficacy of systemic single-dose subcutaneous GCSF administration on IVF success.
• To assess the impact of GCSF on implantation, chemical pregnancy, and clinical pregnancy rates.
• To determine GCSF's effectiveness in infertile women with repeated IVF failure.

Main Methods:

• Multicenter, randomized, controlled trial involving 112 infertile women with repeated IVF failure.
• Participants received either 300 µg subcutaneous GCSF before implantation or a placebo (control group).
• Ovarian stimulation followed the Long Protocol; implantation, chemical, and clinical pregnancy rates were compared.

Main Results:

• Significantly higher successful implantation rates in the GCSF group (18% vs 7.2%, P=0.007).
• Elevated chemical pregnancy (44.6% vs 19.6%, P=0.005) and clinical pregnancy rates (37.5% vs 14.3%, P=0.005) with GCSF.
• GCSF treatment remained significantly associated with improved implantation and pregnancy outcomes after covariate adjustment.

Conclusions:

• Single-dose systemic subcutaneous GCSF administration significantly enhances IVF success.
• GCSF treatment demonstrably increases implantation and pregnancy rates in women with recurrent IVF failure.
• This approach offers a promising strategy for improving IVF outcomes in challenging cases.