Therapeutic role of granulocyte macrophage colony‐stimulating factor ( GM ‐ CSF ) in patients with persistent thin endometrium: A prospective and randomized study

Objective To assess the effect of granulocyte macrophage colony‐stimulating factor ( GM ‐ CSF ) on unresponsive thin (<7 mm) endometrium in women undergoing frozen‐thawed embryo transfer. Methods A single‐center, randomized, prospective study enrolled 304 women with thin unresponsive endometrium from Shanghai Ninth People's Hospital between March 2017 and May 2018. Of them, 161 patients received an intrauterine infusion of GM ‐ CSF and 143 patients served as controls. After hysteroscopy, a gel with or without GM ‐ CSF was administered to fill the uterine cavity completely or up to 5  mL only. The primary outcome was confirmed pregnancy and secondary outcomes included endometrial thickness and implantation rate. Results Patients who were administered GM ‐ CSF had a significantly higher chemical pregnancy rate (35.3% vs 20.0%; P =0.009) and clinical pregnancy rate (28.6% vs 13.3%; P =0.005) compared with patients in the control group. Patients treated with GM ‐ CSF had significantly higher endometrial thickness compared with controls (7.83 ± 1.45 mm vs 7.37 ± 0.70 mm, P =0.003). Conclusion GM ‐ CSF therapy can effectively increase endometrial thickness and improve the clinical pregnancy rate in patients with persistent thin endometrium. The therapeutic role of GM ‐ CSF for infertile women under in vitro fertilization and embryo transfer ( IVF ‐ ET ) treatment can be further explored. Chinese Clinical Trial Register ChiCTR‐IPR‐17011242