The role of G- CSF in recurrent implantation failure: A randomized double blind placebo control trial

Background: Recurrent implantation failure (RIF) is the absence of implantationafter three consecutive In Vitro Fertilization (IVF) cycles with transferring at leastfour good quality embryos in a minimum of three fresh or frozen cycles in a womanunder 40 years. The definition and management of RIF is under constant scrutiny.Objective: To investigate the effects of Granulocyte colony stimulating factor (GCSF)on RIF, pregnancy rate, abortion rate and implantation rates.Materials and Methods: A double blind placebo controlled randomized trial wasconducted at two tertiary university based hospitals. One hundred patients with thehistory 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 ofprogesterone administration of FET cycle. Forty patients were recruited at G-CSFgroup, 40 in saline and 20 in placebo group.Results: 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 positivepregnancy 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 inG-CSF, one in saline group. The implantation rate was 12.3% in G-CSF, 6.1% insaline and 4.7% in placebo group.Conclusion: G-CSF may increase chemical pregnancy and implantation rate inpatients with recurrent implantation failure but clinical pregnancy rate and abortionrate was unaffected.