Can intrauterine infusion of granulocyte colony-stimulating factor or platelet-rich plasma increase implantation rate in women undergoing in vitro fertilization with normal endometrium: boon or bane?

Abstract

Objective: The objective of this study was to investigate if intrauterine infusion of granulocyte colony-stimulating factor (G-CSF) or platelet-rich plasma (PRP) can improve endometrial parameters and the pregnancy rate in patients undergoing fresh embryo transfer with normal endometrial thickness. Materials and Methods: We conducted a retrospective observational study, at one of the assisted reproductive technique centers in central India. Data were collected from the institutional record system which was established as per the standard protocols. Data on a total of 225 patients who had an endometrial thickness >7 mm without any adjunct and underwent fresh embryo transfer in their first in vitro fertilization cycle during the past 2 years were collected and were categorized into three groups: Group A who had received intrauterine infusion of G-CSF (n = 75), Group B who received intrauterine infusion of PRP (n = 75), and Group C who (control group) received no intervention (n = 75). Results: The implantation rate was significantly higher in Group A (37.24%) than in Groups B and C (21.91% and 21.37%, respectively). No significant difference was found in the clinical pregnancy rate among Groups A, B, and C (50.68%, 40.54%, and 37.84%, respectively). Endometrial thickness increased significantly in Group A by approximately 2.3 mm. No significant change in other endometrial parameters in the three groups. The number of biochemical pregnancies was higher in the G-CSF group compared to the other two groups. Conclusion: Intrauterine infusion of G-CSF in women receiving fresh embryo transfer with normal endometrial thickness can increase endometrial thickness and the implantation rate without affecting other endometrial parameters and the cumulative pregnancy rate.