Granulocyte Colony Stimulating Factor for Recurrent Implantation Failure: 5- year Cohort Study Results

Authors Dr. Islam Elkhateb¹ , Prof. Radwa Fahmy², Prof. Wafaa Ramadan², Dr. Ahmed Mourad³, Dr. Nihal El-demiry, ²
Kenzy Elessawy⁴, Prof. Amal Shohayeb² Affiliations ¹Department of Obstetrics and Gynecology, Cairo University Students’ Hospital, Cairo, Egypt ²Department of Obstetrics and Gynecology, Cairo University Kasr Alainy Teaching Hospital, Cairo, Egypt ³Department of Dermatology, Cairo University Kasr Alainy Teaching Hospital, Cairo, Egypt ⁴Newgiza University School of Medicine, Giza, Egypt

INTRODUCTION
Recurrent implantation failure (RIF) remains a major challenge in infertility treatment. RIF significantly affects patients both financially and psychologically. Granulocyte-colony stimulating factor (G-CSF) has shown potential in enhancing embryo implantation and clinical pregnancy rates in RIF patients.
METHODOLOGY
Design: Observational ambispective (prospective + retrospective) cohort study.
Methods:
Conducted at the IVF unit, Cairo University Kasr Alainy
Obstetrics & Gynecology Hospital.
Study period: October 2019 – September 2024.
Approved by the Research Ethics Committee (Code: MD-179-
2019).
Registered under ClinicalTrials.gov Identifier: NCT04998279.
Intervention group: RIF patients who underwent fresh embryo
transfer (ET) between 10/2019 and 9/2023
received intrauterine G-CSF infusion after oocyte pick-up, 3 days before ET. Control group: RIF patients undergoing fresh ET before and after that timeframe, without G-CSF. Exclusion criteria: advanced maternal age, significant uterine anomalies, and immunological or genetic factors affecting implantation.

 

Intrauterine G-CSF significantly improves implantation rates in women with recurrent implantation failure undergoing fresh embryo transfer.

RESULTS
Participants:
40 patients in the study group vs. 39 in the control group. Clinical Pregnancy Rate:
Study group: 27.5% (11/40)
Control group: 17.9% (7/39)
Not statistically significant (P = 0.28) Implantation Rate:
Study group: 0.33 ± 0.25
Control group: 0.33 ± 0.08
Statistically significant improvement (P = 0.04) First Trimester Abortion Rate:
Study group: 18.2% (2/11)
Control group: 42.9% (3/7)
Not statistically significant (P = 0.25) Endometrial Thickness:
Study group showed a mean increase of 1.15 ± 1.5 cm from oocyte pick-up to ET Poor documentation in control group
CONCLUSION
Intrauterine G-CSF infusion in RIF patients undergoing fresh embryo transfer may enhance implantation and clinical pregnancy rates. It may also reduce early abortion rates. Further large-scale studies are needed to confirm these findings and establish clear clinical guidelines.