|An Evaluation Of The Use Of Granulocyte Colony Stimulating Factor As An Adjunct To In Vitro Fertilization In Women Who Have Previously Failed Attempts At Pregnancy With In Vitro Fertilization|
|Tasneem Mohamed1, Mohamed Iqbal Cassim2, Yasmin Adam1|
|1Department of Obstetrics and Gynaecology,WITS,Johannesburg, South Africa
2Bio ART Fertility Centre , Gynaecology and Infertility, Johannesburg, South Africa
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Keywords : G-CSF, IVF, Endometrium, Pregnancy
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Objectives: To evaluate the effects of Granulocyte Colony Stimulating Factor (G-CSF) as an adjunct to Invitro fertilization (IVF). The study looked at the influence of G-CSF on the endometrium and on the achievement of pregnancy.
Materials and Methods: A retrospective cross-sectional study of a subgroup of women attending a fertility clinic in Johannesburg, who had two or more failed IVFs previously. These women underwent a procedure of transvaginal infusion of G-CSF in addition to their IVF protocol. Endometrial thickness was not a criterion for its use.
Results: The group consisted of 49 women, mean age 38.9 years (SD ± 6.11). The mean number of previous IVFs was 3.1 (SD ± 1.76). Mean endometrial thickness pre-GCSF was 7.53mm (SD ± 2.69) and post-GCSF was 9.11mm (SD ± 2.12). The clinical pregnancy rate was 34.69%. Univariate analysis between those that achieved pregnancy and those that didn’t showed that the age difference between the two groups was significant statistically (p=0.0005). G-CSF use was associated with increased pregnancy rates in younger women. Mean endometrial thickness pre and post-GCSF between the two groups was not significant statistically (p>0.05). However the mean change in endometrial thickness in all women regardless of pregnancy outcome was statistically significant (p= 0.0029).
Conclusion: G-CSF is a useful adjunct in the treatment of women aged less than 38 years with recurrent failed IVFs. We reported a statistically significant overall expansion of endometrial thickness with the use of G-CSF but failed to show any association between endometrial expansion and pregnancy outcome.
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