Davari-Tanha Fatemeh, Shahrokh Tehraninejad Ensieh, Ghazi Mohadese, Shahraki Zahra
Department of Reproductive Endocrinology, Women Hospital, Vali-e-Asr Health Reproductive Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Reproductive Endocrinology, Vali-e-Asr Hospital, Vali-e-Asr Health Reproductive Center, Tehran University of Medical Sciences, Tehran, Iran.
Int J Reprod Biomed. 2016 Dec;14(12):737-742.
Recurrent implantation failure (RIF) is the absence of implantation after three consecutive In Vitro Fertilization (IVF) cycles with transferring at least four good quality embryos in a minimum of three fresh or frozen cycles in a woman under 40 years. The definition and management of RIF is under constant scrutiny.
To investigate the effects of Granulocyte colony stimulating factor (G-CSF) on RIF, pregnancy rate, abortion rate and implantation rates.
A double blind placebo controlled randomized trial was conducted at two tertiary university based hospitals. One hundred patients with the history of RIF from December 2011 until January 2014 were recruited in the study. G-CSF 300µg/1ml was administered at the day of oocyte puncture or day of progesterone administration of FET cycle. Forty patients were recruited at G-CSF group, 40 in saline and 20 in placebo group.
The mean age for whole study group was 35.3±4.2 yrs (G-CSF 35.5±4.32, saline 35.3±3.98, placebo 35.4±4.01, respectively). Seventeen patients had a positive pregnancy test after embryo transfer [10 (25%) in G-CSF; 5 (12.5%) in saline; and 2 (10%) in placebo group]. The mean of abortion rates was 17.6% (3), two of them in G-CSF, one in saline group. The implantation rate was 12.3% in G-CSF, 6.1% in saline and 4.7% in placebo group.
G-CSF may increase chemical pregnancy and implantation rate in patients with recurrent implantation failure but clinical pregnancy rate and abortion rate was unaffected.
反复种植失败（RIF）是指40岁以下女性在至少三个新鲜或冷冻周期中连续进行三次体外受精（IVF）周期，每次移植至少四个优质胚胎后仍未着床。RIF的定义和管理一直受到密切关注。
研究粒细胞集落刺激因子（G-CSF）对RIF、妊娠率、流产率和着床率的影响。
在两家大学附属医院进行了一项双盲安慰剂对照随机试验。招募了2011年12月至2014年1月有RIF病史的100名患者。在卵母细胞穿刺日或FET周期的孕酮给药日给予300µg/1ml的G-CSF。G-CSF组招募40名患者，生理盐水组40名，安慰剂组20名。
整个研究组的平均年龄为35.3±4.2岁（G-CSF组为35.5±4.32岁，生理盐水组为35.3±3.98岁，安慰剂组为35.4±4.01岁）。17名患者在胚胎移植后妊娠试验呈阳性[G-CSF组10名（25%）；生理盐水组5名（12.5%）；安慰剂组2名（10%）]。平均流产率为17.6%（3例），其中2例在G-CSF组，1例在生理盐水组。G-CSF组的着床率为12.3%，生理盐水组为6.1%，安慰剂组为4.7%。
G-CSF可能会提高反复种植失败患者的生化妊娠率和着床率，但对临床妊娠率和流产率无影响。
