Gynecologic and Obstetrics Department, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
J Obstet Gynaecol. 2022 Aug;42(6):2480-2485. doi: 10.1080/01443615.2022.2080534. Epub 2022 Jul 5.
This study aimed to evaluate the effect of granulocyte colony stimulating factor (GCSF) on fertility outcomes in women with unexplained infertility after intrauterine insemination (IUI). This study is a randomised clinical trial that was conducted on unexplained infertile women referred to infertility Clinic in Yasuj, Iran. All participants were stimulated by letrozole, clomiphene and HMG during the cycle. When at least one follicle was greater than 18 mm, 5000 IU hCG intramuscularly was administered for ovulation induction and then IUI was performed 34-36 hours later. In GCSF group, 300 μg GCSF subcutaneously administrated in two days after IUI. Control group received routine IUI. The main outcome measures were biochemical pregnancy, clinical pregnancy, abortion and ongoing pregnancy rate. Our results showed no statistically significant difference in the biochemical pregnancy (16.3% vs. 12.2%; =.56), clinical pregnancy (16.3% vs. 8.2%; =.21), abortion (0 vs. 2.04%; =.55) and ongoing pregnancy rates (8.2% vs. 14.2%; =.32) between the control and the G-CSF groups. The results of the current study suggest that systemic administration of 300 μg GCSF in the two days after receiving IUI in patients with unexplained infertility does not offer any beneficial clinical related implantation, and pregnancy rates. IRCT20160524028038N4 Impact statement Unexplained infertility means to the inability of couples in pregnancy after a year without obvious male and female infertility factors. Some patients have not been justified in endometrial function, which leads to the defect of the dialogue between the foetus and endometrium and may lead to implantation failure. Granulocyte colony stimulating factor is produced at the maternal-foetal interface during embryo implantation and is the main part of the uterine-cytokine network that is needed to create and maintain pregnancy. The current study suggests that systemic administration of 300 μg granulocyte colony stimulating factor in the two days after receiving IUI in patients with unexplained infertility does not offer any beneficial clinical related implantation and pregnancy rates. These results may not be generalised to all patients and more randomised controlled trials are needed for the comparison of granulocyte colony stimulating factor effects on women with thin and normal endometrial thickness, efficacy, side effects, and pregnancy outcomes of the intrauterine perfusion versus systemic subcutaneous administration of granulocyte colony stimulating factor in unexplained infertility treated with intrauterine insemination.
本研究旨在评估粒细胞集落刺激因子（GCSF）对不明原因不孕女性宫腔内人工授精（IUI）后生育结局的影响。这是一项在伊朗亚苏季不孕诊所就诊的不明原因不孕女性中进行的随机临床试验。所有参与者均接受来曲唑、氯米芬和 HMG 刺激。当至少一个卵泡大于 18mm 时，肌内注射 5000IU hCG 诱导排卵，然后在 34-36 小时后进行 IUI。在 GCSF 组中，在 IUI 后两天内皮下给予 300μg GCSF。对照组接受常规 IUI。主要观察指标为生化妊娠、临床妊娠、流产和持续妊娠率。我们的结果显示，生化妊娠（16.3%比 12.2%；=.56）、临床妊娠（16.3%比 8.2%；=.21）、流产（0 比 2.04%；=.55）和持续妊娠率（8.2%比 14.2%；=.32）在对照组和 G-CSF 组之间无统计学差异。目前的研究结果表明，在不明原因不孕患者接受 IUI 后两天内系统给予 300μg GCSF 并不能提供任何有益的临床相关着床和妊娠率。
