Immune Therapy to Improve Live Birth Rates in Patients Undergoing Intracytoplasmic Sperm Injection

Background & Objective: Granulosa cells, the endometrium, and the placenta all play a role in the secretion of G-CSF in the reproductive tract. G-CSF affects immunological regulation, which is crucial for enhancing pregnancy viability and maintenance. To evaluate the effects of granulocyte-colony stimulating factor subcutaneous injection on the miscarriage rate, ongoing pregnancy rate, and livebirth rate after single and multiple doses of G-CSF factor.Materials & Methods: At the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies at Al-Nahrain University, a prospective comparison study with a random sample selection was conducted from December ۲۰۲۱ to December ۲۰۲۲. It included ۱۲۱ infertile women who had previously unsuccessful intracytoplasmic sperm injection (ICSI) procedures and who had finished ICSI protocols and reached the embryo transfer day. Patients were divided into three groups on the day of the embryo transfer: The non-G-CSF group (۴۹ patients) received no additional treatment; the single-G-CSF group (۳۱ patients) received a single subcutaneous injection of granulocyte-colony stimulating factor one hour after embryo transfer; and the multiple-G-CSF group (۴۱ patients) received weekly injections of G-CSF until a fetal heartbeat could be detected, starting one hour after the embryo transfer.Results: The multiple G-CSF group had better results in the miscarriage rate, ongoing pregnancy rate, and livebirth rate (۲۳.۵%, ۳۴.۱%, and ۳۱.۷%, respectively) when compared to the single G-CSF group (۴۲.۹%, ۱۶.۱, and ۱۲.۹%, respectively) and the non-G-CSF group (۳۷.۵%, ۱۲.۲%, and ۱۰.۲%, respectively).Conclusion: Multiple subcutaneous G-CSF doses can improve the miscarriage rate, ongoing pregnancy rate, and live birth rate. A single dose of G-CSF for infertile women has no appreciable benefits.