An Evaluation of the Use of G-CSF as an Adjunct to IVF in Women Who Have Previously Failed Attempts at Pregnancy With IVF

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.