Transvaginal perfusion of G-CSF for infertile women with thin endometrium in frozen ET program: a non-randomized clinical trial

We often see patients with a thin endometrium in ART cycles, in spite of standard and adjuvant treatments. Improving endometrial growth in patients with a thin endometrium is very difficult. Without adequate endometrial thickness these patients, likely, would not have reached embryo transfer. We planned this study to investigate the efficacy of intrauterine granulocyte colony-stimulating factor [G-CSF] perfusion in improving endometrium, and possibly pregnancy rates in frozen-thawed embryo transfer cycles. This is a non-randomized intervention clinical trial. Among 68 infertile patients with thin endometrium [-7 mm] at the 12[th]-13[th] cycle day, 34 patients received G-CSF. G-CSF [300 microgram/lniL] to improve endometrial thickness was direct administered by slow intrauterine infusion using IUI catheter. If the endometrium had not reached at least a 7-mm within 48-72 h, a second infusion was given. Endometrial thickness was assessed by serial vaginal ultrasound at the most expanded area of the endometrial stripe. The cycle was cancelled in the patients with thin endometrium [endometrial thickness below 7mm] until 19[th] cycle day ultimately The cycle cancelation rate owing to thin endometrium was similar in G-CSF group [15.20%], followed by [15.20%] in the control group [p=1.00]. The endometrial growth was not different within 2 groups, an improvement was shown between controlled and G-CSF cotreated groups, with chemical [39.30% vs. 14.30%] and clinical pregnancy rates [32.10% vs. 12.00%] although were not significant. Our study fails to demonstrate that G-CSF has the potential to improve endometrial thickness but has the potential to improve chemical and clinical pregnancy rate of the infertile women with thin endometrium in frozen-thawed embryo transfer cycle

Effect of vitamin D insufficiency treatment on fertility outcomes in frozen-thawed embryo transfer cycles: a randomized clinical trial

Frozen- thawed embryo transfer is an essential part of ART treatment and outcomes of this procedure are associated with several clinical factors. Several studies have showed an increase level of IVF outcomes in women with sufficient vitamin D. whether treatment of vitamin D insufficiency can improve pregnancy rates in frozen-thawed embryo transfer cycles. This is an interventional, randomized clinical trial. Serum 25-[OH] vitamin D level of 128 women who had undergone IVF/ICSI with cryopreservation of embryos was checked. One hundred fourteen infertile women with insufficient serum vitamin D [less than 30 ng/ml] were included in the study. Fifty seven women were treated with supplementary vitamin D, 50000 IU weekly, for 6-8 weeks and fifty seven women were received no supplementation. One hundred six women completed frozen thawed embryo transfer cycles and included in the final analysis. Primary and secondary outcomes were chemical and clinical pregnancy respectively. Our study did not show any significant difference between vitamin D insufficient and treated women in term of chemical [29.40% vs. 29.10% respectively, p=1.00] or clinical [25.50% vs. 21.80% respectively, p=0.81] pregnancy rates. Vitamin D insufficiency treatment is not associated with higher pregnancy rate in frozen-thawed embryo transfer cycles