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Jul 2019, Vol 7, Issue 3
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Original Article
An Evaluation of the Use of G-CSF as an Adjunct to IVF in Women Who Have Previously Failed Attempts at Pregnancy With IVF
Tasneem Mohamed1, Yasmin Adam1, Mohamed Iqbal Cassim2
1Department of Obstetrics and Gynaecology, WITS, Johannesburg, South Africa
2BioART Fertility Centre, Gynaecology and Infertility, Johannesburg, South Africa

IJWHR 2019; 7: 269-275
DOI: 10.15296/ijwhr.2019.45
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Keywords : G-CSF, IVF, Endometrium, Pregnancy
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Abstract
Objectives: The present study aimed to evaluate the effects of granulocyte colony-stimulating factor (G-CSF) as an adjunct to in vitro fertilization (IVF). In other words, it delved into the influence of G-CSF on the endometrium and the achievement of pregnancy.

Materials and Methods: This retrospective cross-sectional study was conducted on a subgroup of women with two or more previously failed IVFs, who attended a fertility clinic in Johannesburg. These women underwent a procedure of transvaginal infusion of G-CSF in addition to their IVF protocol although endometrial thickness was not a criterion for G-CSF use.

Results: The group included 49 women with a mean age of 38.9 years (SD ± 6.11). The mean number of previous IVFs was 3.1 (SD ± 1.76). The mean endometrial thickness pre-G-CSF and post-G-CSF was 7.53 mm (SD ± 2.69) and 9.11 mm (SD ± 2.12), respectively. The clinical pregnancy rate was 34.69%. Univariate analysis between the groups of women who achieved or failed to achieve pregnancy showed that the age difference between the two groups was statistically significant (P = 0.0005). Further, G-CSF use was associated with increased pregnancy rates in younger women. Finally, although the mean endometrial thickness pre and post-G-CSF were not statistically significant between the two groups (P > 0.05), the mean change in endometrial thickness was statistically significant in all women regardless of pregnancy outcome (P = 0.0029).

Conclusions: In general, G-CSF is considered as a useful adjunct for the treatment of women with recurrent failed IVFs and aged less than 38 years. Based on the findings, a statistically significant overall expansion of endometrial thickness was reported by using G-CSF. However, it failed to show any association between endometrial expansion and pregnancy outcome.

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