Clinical study of tamoxifen and granulocyte colony stimulating factor to improve endometrial receptivity in patients with refractory thin endometrium
10.3760/cma.j.cn101441-20210903-00388
- VernacularTitle:他莫昔芬与粒细胞集落刺激因子改善难治性薄型子宫内膜患者子宫内膜容受性的临床观察
- Author:
Li CHEN
1
;
Zhijin HOU
1
;
Lin CHEN
1
;
Jiamei SONG
1
;
Yushi MENG
1
Author Information
1. 昆明医科大学第二附属医院生殖医学科，昆明 650032
- Publication Type:Journal Article
- Keywords:
Tamoxifen;
Granulocyte colony stimulating factor;
Receptors, estrogen;
Thin endometrium
- From:
Chinese Journal of Reproduction and Contraception
2022;42(12):1274-1279
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of tamoxifen and granulocyte colony stimulating factor (G-CSF) in the treatment of refractory thin endometrium.Methods:Prospective cohort study was performed. Patients treated in the Department of Reproductive Medicine of the Second Affiliated Hospital of Kunming Medical University from December 2019 to December 2020 were included, they all suffered from cancellation of fresh transplantation cycle due to endometrial thickness less than 7 mm, and estrogen treatment was given in the following frozen-thawed embyro transfer cycle but the thickness of endometrium still under 7 mm. They were divided into three groups according to their wishes: group A was treated with tamoxifen ( n=40), group B was treated with intrauterine perfusion of G-CSF ( n=38), and group C was treated with tamoxifen combined with intrauterine perfusion of G-CSF ( n=36). The endometrial receptivity and pregnancy outcomes among the three groups were compared. Results:There were no significant differences in the clinical characteristics of patients and the thickness of endometrium before treatment among the three groups (all P>0.05). The endometrial thickness after treatment was significantly improved compared with those before treatment among the three groups ( P<0.001). After treatment, endometrial thickness of group A [8.00(8.00, 9.00) mm] and group C [8.00(8.00, 10.00) mm] was higher than that of group B [7.00(7.00, 8.00) mm, P=0.002, P=0.001]. The type of Ⅲ endometrial blood flow of group C [72.2% (26/36)] was significantly improved compared with group A [40.0% (16/40), P=0.005)] and group B [42.1% (16/38), P=0.009]. The resistance index (RI), pulsatility index (PI) and systolic peak velocity/diastolic velocity (S/D) of group B (0.61±0.08, 0.81±0.11, 2.05±0.12) and group C (0.60±0.11, 0.78±0.15, 1.99±0.19) were lower than those of group A (0.66±0.04, 0.94±0.10, 2.17±0.06), and the differences among the three groups were statistically significant (RI: P=0.009, P=0.001; PI: P<0.001, P<0.001; S/D: P<0.001, P<0.001). The embryo implantation rate and the clinical pregnancy rate of group C were higher than those of group A and group B, and the early abortion rate of group C was lower than that of group A and group B, but there were no significant differences among the three groups (all P>0.05). Conclusion:Three treatment schemes have certain curative effects on improving the endometrial receptivity and pregnancy outcome of patients with refractory thin endometrium, among which tamoxifen combined with G-CSF is superior to single drug in improving the endometrial receptivity, but the combined group has not shown significant advantages in pregnancy outcome.
