Objective: To evaluate GCSF ability to improve pregnancy rate in women with repeated implantation failure
Design: Randomized clinical trial
Setting and conduct: 90 women referred to Yazd research and clinical center for infertility, 2014- 2015 are studied in 2 groups (n=45).
Inclusion and Exclusion criteria: Women with history of recurrent implantation failure, between 20-45 years old, and history of at least 2 implantation failures are included. Participants with sickle cell disease, chronic neutropenia, history of malignancy, renal failure, congenital fructose intolerance, respiratory infection, endometriosis and sever male factor were excluded.
Intervention: For all of participants, in the second day of menstrual cycle, 150 mg of recombinant human follicle stimulating hormone (Gonal-F) is injected subcutaneously for 5 days. Serial Trans-vaginal sonography is performed to detect the mature follicle (14 mm follicle). Then 0.25 mg GnRH antagonist (Cetrotide) is injected subcutaneously. While three follicles reach to 17mm, 100000 mg HCG is injected. After 36 hours Trans-vaginal Egg retrieval is done under sedation. Then 30ml (300 mg/ml) GCSF is administered by slow Trans-cervical intrauterine infusion in intervention group patients. The ccontrol group will continue their cycle without any intervention.
Main outcome measures (variable): Pregnancy outcomes are assessed based on chemical pregnancy (positive pregnancy test) after 2 weeks and clinical pregnancy (gestational sac and fetal heart on ultrasound examination) 2-3 weeks after positive pregnancy test.