ABSTRACT
Background: Endometrium undergoes several changes in structure and cellular composition during pregnancy. Granulocyte Colony-stimulating Factor [GCS-F] is an important cytokine with critical role in embryo implantation and pregnancy. The aim of the present study was to evaluate the impact of intrauterine injection of G-CSF in patients who suffer from unexplained recurrent miscarriage [RM]
Methods: In the present randomized clinical trial, a total of 68 patients were randomly allocated into two study groups including intrauterine G-CSF [n=23, 300mg] injection and control group [n=27, no G-CSF injection]. Eighteen out of 68 patients were excluded from the final analysis due to different reasons. All patients were in Ovulation Induction [I/O] cycle. In G-CSF group, intrauterine injection of G-CSF was done twice in the cycle. All enrolled patients were under 40 years old and had at least two unexplained pregnancy losses. Pregnancy was evaluated by titer of bhCG, presence of gestational sac [implantation] and fetal heart rate [clinical pregnancy] was assessed by vaginal ultrasonography. Student's T test and Mann-Whitney U were used for analysis. The p
Results: No significant differences were observed between the two study groups when the rates of chemical pregnancy [26.1%vs.29.6%, p=0.781], implantation [26.1%vs.22.2%, p=0.750], clinical pregnancy [17.4% vs.11.1%, p=0.689] and abortion [33%vs.37.5%, p=0.296] were compared
Conclusion: In our study, no significant difference was observed between the two study groups when the rates of chemical pregnancy, implantation, clinical pregnancy and abortion were compared
ABSTRACT
Coasting is the most common method used in the prevention of ovarian hyperstimulation syndrome [OHSS] acting through vascular endothelial growth factor [VEGF] reduction. However, the pregnancy rate is reported to fall with coasting when it takes more than three days. Recently low-dose cabergoline, a selective D2 dopamine receptor agonist has been proven to selectively reduce vascular permeability without affecting angiogenesis and seems to be able to decrease the rate of OHSS without affecting pregnancy rate. This clinical trial was performed on 60 women in assisted reproductive technologies [ART] cycles at risk of OHSS, having at least 20 follicles in their ovaries [mostly /= 3000pg/mL. Patients were divided into two equal groups. In group A, oral cabergoline 0.5 nig/day was given for seven days after hCG administration; while in group B gonadotropin administration was halted until serum estradiol levels reached less than 3000pg/mL before hCG administration. The main outcome measurements compared were rates of pregnancy and severity of OHSS. Total number of oocytes, metaphase II oocytes, fertilization and clinical pregnancy rates were higher in group A [p<0.05]. Severe OHSS was not found in either group. Moderate OHSS was seen in one subject in the cabergoline group versus seven in the coasting group. Cabergoline seems to be a safe drug for prevention of moderate-severe OHSS