The Application Of Perfusion Of Granulocyte Colony-stimulating Factor In Uterine Cavity Combined With Low Molecular Weight Heparin Injection In FET Women With Thin Endometrium

Objective: To investigate the clinical effect of intrauterine perfusion of the granulocyte colony-stimulating factor(G-CSF)combined with low molecular weight heparin(LMWH)on the clinical outcomes of freeze-thaw embryo transfer(FET)in those patients with thin endometrium.Methods: A total of 175 patients with thin endometrium who received FET at the Reproductive Medicine Center of the First Hospital of Shanxi Medical University from June 2018 to October 2019 were selected and divided into 3 groups according to the patient’s own wishes.Group A: 63 patients only received hormone replacement therapy as the control group.Group B: 52 patients received hormone replacement therapy and intrauterine G-CSF perfusion.Group C: 60 patients received hormone replacement therapy and intrauterine G-CSF perfusion and subcutaneous injection of LMWH.Endometrial thickness,endometrial blood flow resistance index(RI),pulse index(PI),cycle cancellation rate,embryo implantation rate,clinical pregnancy rate,early abortion rate,ectopic pregnancy rate and other indicators of the three groups were compared.Results: 1.There were no statistically significant differences among the three groups of patients age,years of infertility,body mass index(BMI),type of infertility,and number of transplanted D3 cleavage embryos(P>0.05).2.The endometrial thickness of the three groups of patients increased after treatment,and the difference was statistically significant(P<0.05),and the difference in D8 endometrial thickness of the three groups of patients was not statistically significant(P>0.05).Comparison of the endometrial thickness and endometrial increase on the endometrial transformation day of the three groups of patients was statistically significant(P<0.05);The endometrial thickness and the increase in the endometrium on the day of endometrial transformation in groups B and C were higher than those in group A,and the difference was statistically significant(P < 0.05),while the difference between group B and group C was not statistically significant(P>0.05).3.There was no significant difference in the proportion of D8 Ⅱ+Ⅲ blood flow,PI and RI among the three groups(P>0.05);after treatment,the proportion of type Ⅱ+Ⅲ blood flow in the B and C groups increased significantly,while PI and RI decreased,The difference was statistically significant(P<0.05).There were statistically significant differences in the ratio of type Ⅱ+Ⅲ blood flow,PI,and RI between the 3 groups of patients on the day of intimal transformation(P<0.05);compared with group A,the ratio of type Ⅱ+Ⅲ blood flow in group B and C was higher.PI and RI were low,and the difference was statistically significant(P<0.05);there was no statistically significant difference between group B and group C(P>0.05).4.The three groups of patients had statistically significant differences in cycle cancellation rate,clinical pregnancy rate,early miscarriage rate,and embryo implantation rate(P<0.05),and the difference in ectopic pregnancy rate was not statistically significant(P>0.05).Compared with group A,the cycle cancellation rate of group B and group C decreased,and the clinical pregnancy rate and embryo implantation rate increased,The difference was statistically significant(P<0.05),and the difference between groups B and C was not statistically significant(P>0.05).Compared with group B,the early abortion rate in group C was significantly reduced,and the difference was statistically significant(P<0.05).Conclusion: 1.Intrauterine perfusion of G-CSF during the FET cycle of patients with thin endometrium can significantly improve the endometrial thickness,the blood flow of endometrium,the embryo implantation rate and clinical pregnancy rate.2.The combined LMWH injection can reduce the early abortion rate.