Effect Of Granulocyte Colony Stimulating Factor On Endometrium

Objective: This study used granulocyte colony stimulating factor(G-CSF)do the uterine perfusion in patients diagnosed with repeated implant failure(RIF).We meatured endometrial receptivity under ultrasound before and after the uterine perfusion to evaluate the inprovement of endometrial receptivity.The aim was to explore the effect of G-CSF on endometrium of patients with RIF for unknown reasons as well as to provide ideas for clinical diagnosis and treatment.Methods: In this study,a prospective study method was adopted to select 80 patients with unexplained repeated implantation failure who were admitted to xx hospital during September 2018 to December 2019.The patients were numbered in the order of time of visit,and the patients were randomly divided into control group and intrauterine perfusion group according to 1:1 by random number list.Before starting the artificial cycle and intrauterine perfusion treatment,the benefits and risks of relevant treatment and operation were explained to the patients both in the two groups according to the grouping results,and the operation could only be carried out with the consent of the patients.The other 40 patients received normal manual cycle preparation with no other special treatment were set as the control group(to avoid technical differences in clinical operation,intrauterine perfusion in this study was all operated by the same physician,and the detection of relevant data under three-dimensional energy ultrasound was also performed by the same physician).Three-dimensional energy ultrasound was performed on the 7th and 14 th days of the artificial cycle,respectively,and thesubendometrial blood flow parameters of the two groups were collected: resistance index(RI),vascularity index(VI),flow index(FI),and endometrial volume Thickness(Em)was recorded and whether the patients had type A endometrium was recorded.On the 3rd day of ketone conversion,the endometrium thickness of the two groups was measured by ultrasound again.Finally,we analyzed if the pregnancy rate of embryo implantation after treatment has statistical differences between the two groups.In this study,SPSS statistical software was used for data analysis to explore the effect of granulocyte colony stimulating factor uterine perfusion on the endometrium of RIF patients in clinic,and whether this operation can improve the clinical pregnancy rate of such patients.Results :1.Comparison of baseline data between the perfusion group and the control group: after collecting baseline data of infertility years and Body Mass Index(BMI)of the perfusion group and the control group,there was no statistical difference between them(P>0.05).2.Contrast of endometrial thickness at day 7,day 14 of the artificial cycle and day 3 of progesterone transformation: the degree of endometrial thickening in the perfusion group was more significant and statistically significant(P<0.05).3.Contrast between the 7th day of the artificial cycle and the 14 th day of the artificial cycle(type A intima rate): the proportion of type A intima in the perfusion group was larger and statistically significant(P<0.05).4.Two groups had no significant difference in intimal RI?VI?VFI and intimal volume at 7th day of artificial cycle(p>0.05);perfusion group had significantly lower intimal RI at 14 th day of artificial cycle than control group(p<0.05),and intimal volume was significantly higher than control group(0.05).5.Embryo implantation rate and pregnancy rate of patients after treatment:according to statistics,the pregnancy rate of the g-csf perfusion group was17.65%(6/34),which was slightly higher than that of the control group(15.79%(6/38),but there was no statistical difference between the two groups,(P>0.05).Embryo implantation rate: after statistics,it was found that although the embryo implantationrate of intrautum perfusion group was 11.90%(10/84),slightly higher than the control group's 10.11%(9/89),there was no statistical difference between the two groups(P>0.05).Conclusion: Granulocyte colony stimulating factor(g-csf)intrauterine perfusion plays a positive role in improving endometrial thickness and blood supply in patients with unexplained repeated implantation failure,and can improve endometrial receptivity.However,the specific effective degree measurement standard and the improvement of the final pregnancy outcome of RIF patients still need to be further studied and deliberated,so as to facilitate the clinical application and promotion of this treatment program.