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Kashani, L., Moini, A., Esfidani, T., Yamini, N., & Mohiti, S. (2021). Effect of intrauterine granulocyte-colony stimulating factor administration on in vitro fertilization outcome in women with moderate-to-severe endometriosis: An RCT. International Journal of Reproductive BioMedicine (IJRM), 19(8), 733-740. https://doi.org/10.18502/ijrm.v19i8.9621
https://doi.org/10.18502/ijrm.v19i8.9621
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Ladan Kashani
Ladan Kashani
Department of Obstetrics and Gynecology, Arash Womens’ Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Ashraf Moini
Ashraf Moini
Department of Obstetrics and Gynecology, Arash Womens’ Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Tayebeh Esfidani
Tayebeh Esfidani
Department of Obstetrics and Gynecology, Arash Womens’ Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Nazila Yamini
Nazila Yamini
Department of Obstetrics and Gynecology, Arash Womens’ Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Shima Mohiti
Shima Mohiti
Department of Obstetrics and Gynecology, Arash Womens’ Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Published Date
- Sep 9, 2021
Effect of intrauterine granulocyte-colony stimulating factor administration on in vitro fertilization outcome in women with moderate-to-severe endometriosis: An RCT
Abstract
Background: Nearly 25-50% of infertile women have endometriosis. There are reports of disorders in the expression of granulocyte colony-stimulating factor (G-CSF) receptors in women with endometriosis.
Objective: To examine the effect of intrauterine administration of G-CSF in in vitro fertilization (IVF) cycles on the fertility rate of infertile women with moderate-to-severe endometriosis.
Materials and Methods: This clinical trial was conducted on 66 infertile women with moderate-to-severe endometriosis, undergoing IVF and intracytoplasmic sperm injection (ICSI). The participants were allocated into two groups via simple randomization: the G-CSF (n = 27) and control (n = 39) groups. In the G-CSF intervention group, on the oocyte pick-up day, immediately after an ovarian puncture, 300 μg of G-CSF was injected through a transcervical catheter under abdominal ultrasound guide to visualize flushing into the uterine cavity. Women in the control group received no intervention. The two groups were evaluated for clinical pregnancy.
Results: No significant difference was noted in the demographic characteristics of the two groups. The rate of clinical pregnancy was 28.2% in the control group and 25.9% in the G-CSF group, indicating no significant difference (p = 0.83).
Conclusion: The results showed that the intrauterine injection of G-CSF had no effects on pregnancy in women with stage-3/4 endometriosis undergoing IVF.
Key words: G-CSF, In vitro fertilization, Endometriosis, Pregnancy.
References
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[2] Vitale SG, Capriglione S, Peterlunger I, La Rosa VL, Vitagliano A, Noventa M, et al. The role of oxidative stress and membrane transport systems during endometriosis: A fresh look at a busy corner. Oxid Med Cell Longevit 2018; 2018: 1–14.
[3] Benaglia L, Candotti G, Papaleo E, Pagliardini L, Leonardi M, Reschini M, et al. Pregnancy outcome in women with endometriosis achieving pregnancy with IVF. Hum Reprod 2016; 31: 2730–2736.
[4] Moldenhauer LM, Keenihan SN, Hayball JD, Robertson SA. GM-CSF is an essential regulator of T cell activation competence in uterine dendritic cells during early pregnancy in mice. J Immunol 2010; 185: 7085–7096.
[5] Young S, Hoff H, Matson B, Fitz V, Yuan L, Mathyk B, et al. Endometriosis reduces granulocyte colony stimulating factor receptor (GCSFR) expression: A mechanism reducing GCSF-mediated stromal adrenomedulin expression. Fertil Steril 2017; 108: e82–e83.
[6] Barad DH, Yu Y, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, et al. A randomized clinical trial of endometrial perfusion with granulocyte colonystimulating factor in in vitro fertilization cycles: Impact on endometrial thickness and clinical pregnancy rates. Fertil Steril 2014; 101: 710–715.
[7] Kamath MS, Chittawar PB, Kirubakaran R, Mascarenhas M. Use of Granulocyte-colony stimulating factor in assisted reproductive technology: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2017; 214: 16–24.
[8] Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, et al. The international glossary on infertility and fertility care, 2017. Hum Reprod 2017; 32: 1786–1801.
[9] Metcalf D. The granulocyte-macrophage colonystimulating factors. Science 1985; 229: 16–22.
[10] Nagata S, Tsuchiya M, Asano S, Kaziro Y, Yamazaki T, Yamamoto O, et al. Molecular cloning and expression of cDNA for human granulocyte colonystimulating factor. Nature 1986; 319: 415–418.
[11] Cavalcante MB, Costa FDS, Barini R, Júnior EA. Granulocyte colony-stimulating factor and reproductive medicine: A review. Iran J Reprod Med 2015; 13: 195–202.
[12] Eftekhar M, Naghshineh E, Khani P. Role of granulocyte colony-stimulating factor in human reproduction. J Res Med Sci 2018; 23: 7.
[13] Xu B, Zhang Q, Hao J, Xu D, Li Y. Two protocols to treat thin endometrium with granulocyte colonystimulating factor during frozen embryo transfer cycles. Reprod Biomed Online 2015; 30: 349–358.
[14] Zhang L, Xu WH, Fu XH, Huang QX, Guo XY, Zhang L, et al. Therapeutic role of granulocyte colonystimulating 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.
[15] Gleicher N, Vidali A, Barad DH. Successful treatment of unresponsive thin endometrium. Fertil Steril 2011; 95: 2123.
[16] Li Y, Pan P, Chen X, Li L, Li Y, Yang D, et al. Granulocyte colony-stimulating factor administration for infertile women with thin endometrium in frozen embryo transfer program. Reprod Sci 2014; 21: 381– 385.
[17] Eftekhar M, Sayadi M, Arabjahvani F. Transvaginal perfusion of G-CSF for infertile women with thin endometrium in frozen ET program: A nonrandomized clinical trial. Iran J Reprod Med 2014; 12: 661–666.
[18] Jain S, Mahey R, Malhotra N, Kalaivani M, Sangeeta P, Bhatt A, et al. Effect of intrauterine perfusion of granulocyte colony-stimulating factor on endometrial parameters and in vitro fertilization outcome in women undergoing in vitro fertilization/intracytoplasmic sperm injection cycles: A randomized controlled trial. J Hum Reprod Sci 2018; 11: 254–260.
[19] Gupta S, Goldberg JM, Aziz N, Goldberg E, Krajcir N, Agarwal A. Pathogenic mechanisms in endometriosis-associated infertility. Fertil Steril 2008; 90: 247–257.
[20] Harb H, Gallos I, Chu J, Harb M, Coomarasamy A. The effect of endometriosis on in vitro fertilisation outcome: A systematic review and meta−analysis. BJOG 2013; 120: 1308–1320.
[21] Macer ML, Taylor HS. Endometriosis and infertility: A review of the pathogenesis and treatment of endometriosis-associated infertility. Obstet Gynecol Clin 2012; 39: 535–549.
[22] Garrido N, Navarro J, Garcia-Velasco J, Remohi J, Pellicer A, Simon C. The endometrium versus embryonic quality in endometriosis-related infertility. Hum Reprod Update 2002; 8: 95–103.
[23] González-Comadran M, Schwarze JE, Zegers- Hochschild F, Maria do Carmo BS, Carreras R, Checa MÁ. The impact of endometriosis on the outcome of assisted reproductive technology. Reprod Biol Endocrinol 2017; 15: 8.
[24] Turocy JM, Benacerraf BR. Transvaginal sonography in the diagnosis of deep infiltrating endometriosis: A review. J Clin Ultrasound 2017; 45: 313–318.
[25] Pop-Trajkovic S, Popović J, Antić V, Radović D, Stavanovic M, Vukomanović P. Stages of endometriosis: Does it affect in vitro fertilization outcome. Taiwan J Obstet Gynecol 2014; 53: 224–226. Page
[2] Vitale SG, Capriglione S, Peterlunger I, La Rosa VL, Vitagliano A, Noventa M, et al. The role of oxidative stress and membrane transport systems during endometriosis: A fresh look at a busy corner. Oxid Med Cell Longevit 2018; 2018: 1–14.
[3] Benaglia L, Candotti G, Papaleo E, Pagliardini L, Leonardi M, Reschini M, et al. Pregnancy outcome in women with endometriosis achieving pregnancy with IVF. Hum Reprod 2016; 31: 2730–2736.
[4] Moldenhauer LM, Keenihan SN, Hayball JD, Robertson SA. GM-CSF is an essential regulator of T cell activation competence in uterine dendritic cells during early pregnancy in mice. J Immunol 2010; 185: 7085–7096.
[5] Young S, Hoff H, Matson B, Fitz V, Yuan L, Mathyk B, et al. Endometriosis reduces granulocyte colony stimulating factor receptor (GCSFR) expression: A mechanism reducing GCSF-mediated stromal adrenomedulin expression. Fertil Steril 2017; 108: e82–e83.
[6] Barad DH, Yu Y, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, et al. A randomized clinical trial of endometrial perfusion with granulocyte colonystimulating factor in in vitro fertilization cycles: Impact on endometrial thickness and clinical pregnancy rates. Fertil Steril 2014; 101: 710–715.
[7] Kamath MS, Chittawar PB, Kirubakaran R, Mascarenhas M. Use of Granulocyte-colony stimulating factor in assisted reproductive technology: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2017; 214: 16–24.
[8] Zegers-Hochschild F, Adamson GD, Dyer S, Racowsky C, de Mouzon J, Sokol R, et al. The international glossary on infertility and fertility care, 2017. Hum Reprod 2017; 32: 1786–1801.
[9] Metcalf D. The granulocyte-macrophage colonystimulating factors. Science 1985; 229: 16–22.
[10] Nagata S, Tsuchiya M, Asano S, Kaziro Y, Yamazaki T, Yamamoto O, et al. Molecular cloning and expression of cDNA for human granulocyte colonystimulating factor. Nature 1986; 319: 415–418.
[11] Cavalcante MB, Costa FDS, Barini R, Júnior EA. Granulocyte colony-stimulating factor and reproductive medicine: A review. Iran J Reprod Med 2015; 13: 195–202.
[12] Eftekhar M, Naghshineh E, Khani P. Role of granulocyte colony-stimulating factor in human reproduction. J Res Med Sci 2018; 23: 7.
[13] Xu B, Zhang Q, Hao J, Xu D, Li Y. Two protocols to treat thin endometrium with granulocyte colonystimulating factor during frozen embryo transfer cycles. Reprod Biomed Online 2015; 30: 349–358.
[14] Zhang L, Xu WH, Fu XH, Huang QX, Guo XY, Zhang L, et al. Therapeutic role of granulocyte colonystimulating 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.
[15] Gleicher N, Vidali A, Barad DH. Successful treatment of unresponsive thin endometrium. Fertil Steril 2011; 95: 2123.
[16] Li Y, Pan P, Chen X, Li L, Li Y, Yang D, et al. Granulocyte colony-stimulating factor administration for infertile women with thin endometrium in frozen embryo transfer program. Reprod Sci 2014; 21: 381– 385.
[17] Eftekhar M, Sayadi M, Arabjahvani F. Transvaginal perfusion of G-CSF for infertile women with thin endometrium in frozen ET program: A nonrandomized clinical trial. Iran J Reprod Med 2014; 12: 661–666.
[18] Jain S, Mahey R, Malhotra N, Kalaivani M, Sangeeta P, Bhatt A, et al. Effect of intrauterine perfusion of granulocyte colony-stimulating factor on endometrial parameters and in vitro fertilization outcome in women undergoing in vitro fertilization/intracytoplasmic sperm injection cycles: A randomized controlled trial. J Hum Reprod Sci 2018; 11: 254–260.
[19] Gupta S, Goldberg JM, Aziz N, Goldberg E, Krajcir N, Agarwal A. Pathogenic mechanisms in endometriosis-associated infertility. Fertil Steril 2008; 90: 247–257.
[20] Harb H, Gallos I, Chu J, Harb M, Coomarasamy A. The effect of endometriosis on in vitro fertilisation outcome: A systematic review and meta−analysis. BJOG 2013; 120: 1308–1320.
[21] Macer ML, Taylor HS. Endometriosis and infertility: A review of the pathogenesis and treatment of endometriosis-associated infertility. Obstet Gynecol Clin 2012; 39: 535–549.
[22] Garrido N, Navarro J, Garcia-Velasco J, Remohi J, Pellicer A, Simon C. The endometrium versus embryonic quality in endometriosis-related infertility. Hum Reprod Update 2002; 8: 95–103.
[23] González-Comadran M, Schwarze JE, Zegers- Hochschild F, Maria do Carmo BS, Carreras R, Checa MÁ. The impact of endometriosis on the outcome of assisted reproductive technology. Reprod Biol Endocrinol 2017; 15: 8.
[24] Turocy JM, Benacerraf BR. Transvaginal sonography in the diagnosis of deep infiltrating endometriosis: A review. J Clin Ultrasound 2017; 45: 313–318.
[25] Pop-Trajkovic S, Popović J, Antić V, Radović D, Stavanovic M, Vukomanović P. Stages of endometriosis: Does it affect in vitro fertilization outcome. Taiwan J Obstet Gynecol 2014; 53: 224–226. Page