A Comparison of Endometrial Thickness and Pregnancy Outcomes in Two Methods of Intrauterine Injection and Subcutaneous Injection of GCSF in Infertile Women Candidates for IVF

An endometrial thickness of less than 7 mm adversely affects pregnancy outcomes. There is also ample evidence of the impact of granulocyte colony-stimulating factor (G-CSF) on treatment-resistant thin endometrium. Therefore, this study compares the effects of intrauterine and subcutaneous injections of G-CSF on increasing endometrial thickness (ET) and pregnancy outcomes in infertile women who were candidates for in vitro fertilization (IVF).

In the current randomized, double-blind clinical trial, 34 patients with a history of failed IVF cycles and treatment-resistant thin endometrium were randomized into two routes of G-CSF injection, i.e., intrauterine and subcutaneous, by using a random number table method. Outcomes including ET and chemical and clinical pregnancy rates were compared in two groups.

ET increased significantly in both groups after G-CSF administration (intrauterine and subcutaneous); however, this increase in thickness was significantly greater in the intrauterine injection group than in the subcutaneous injection group. Pregnancy outcomes were similar in two groups. Drug side effects were significantly lower in the intrauterine injection group than in the subcutaneous injection group.

G-CSF can significantly increase ET in cases of repeated IVF failure, and intrauterine injection of this drug was more effective than subcutaneous injection.