G-CSF Improves Clinical Pregnancy Rate And Changes Of Peripheral Blood Cytokines In Patients With Recurrent Implantation Failure

Objective:To investigate the effect of intrauterine infusion granulocyte colony-stimulating factor(G-CSF)on the clinical outcome of patients with repeated implant failure(RIF)and the related mechanism of G-CSF on endometrial receptivity.Methods:RIF patients who underwent embryo transfer at the Reproductive Center of the First People's Hospital of Changde from January 2018 to June 2019 were selected.According to the inclusion and exclusion criteria,a total of 59 cases that met the criteria were included.According to the voluntary principle of informed consent,RIF patients who were willing to perform intrauterine infusion of G-CSF 100 ?g on the endometrial progesterone conversion day were in the G-CSF group(32 cases).RIF patients without G-CSF intrauterine infusion were the control group(27 cases).Biochemical pregnancy rate,clinical pregnancy rate,embryo planting rate,early abortion rate,ectopic pregnancy rate and other indicators be-tween the G-CSF group and the the control group were obsereved and compared.the cytokines(IL-2,TNF-?,IFN-?,IL-4,IL-6,IL-10)level in peripheral blood of patients before and after progesterone conversion also was obsereved and compared.Finally,the data was organized,and statistical analysis of the research data was performed using SPSS25.0 software,than the conclusion was down.Results:1.The clinical pregnancy rate(46.88% vs.22.22%)of the GCSF group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).The biochemical pregnancy rate(50.00 % vs.29.63%)and the embryo implantation rate(23.38% vs.14.52%)of patients between the G-CSF group and the control group were not statistically significant(P>0.05),but the G-CSF group had an upward trend compared with the control group.G-CSF group and control group patients in the early stage abortion rate(6.67% vs.16.67%)was not statistically significant(P>0.05),but the G-CSF group had a downward trend compared with the control group.There was no ectopic pregnancy in the G-CSF group,but there was one ectopic pregnancy in the control group.2.Six cytokines in peripheral blood of 32 patients undergoing intrauterine infusion G-CSF before and after treatment were compared.TNF-? after intrauterine infusion G-CSF(5.79±2.46 pg/ml)was significantly lower than before intrauterine infusion G-CSF(6.64±1.94 pg/ml),the difference was statistically significant(P<0.05).IL-6 after intrauterine infusion G-CSF(17.66±8.56 pg/ml)was significantly higher than before intrauterine infusion G-CSF(7.41±1.25 pg/ml),the difference was statistically significant(P<0.05).IL-2,IFN-?,IL-4 and IL-10 were no statistically significant difference between intrauterine infusion G-CSF treatment before and after treatment(P>0.05),but IL-2 and IFN-? after intrauterine infusion G-CSF treatment showed a downward trend compared with before treatment,IL-4.IL-10 after intrauterine infusion G-CSF treatment had an upward trend before treatment.Conclusions:Intrauterine infusion G-CSF can increase the expression of cytokine IL-6 and reduce the expression of cytokine TNF-?,which is conducive to embryo implantation and improves the clinical pregnancy rate.Intrauterine infusion G-CSF may improve the pregnancy outcome of RIF patients to a certain extent,and can be used for clinical treatment.Intrauterine infusion G-CSF can provide a reference method for clinical treatment of RIF patients.