الفهرس 
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Abstract
This study was conducted on patients attended to Infertility center of obstetrics and gynecology department of faculty of medicine El-Minia University in period from March 2015 to March 2016, the study included 60 patients aged between 20 – 35 years old complaining of primary or secondary infertility had been recruited into the study.
This study aimed at investigate the efficacy of intrauterine granulocyte colony-stimulating factor (G-CSF) perfusion in improving endometrium thicness, and possibly pregnancy rates in frozen-thawed embryo transfer cycles.
Groups of the patients:
All patients were randomized in two groups according to the mode of treatment.
group A: Include 30 infertile patients with previous filed ICSI and prepared for frozen embryoes transfere cycle injected by 100 IU of GCSF (Gyneleucine) 100 IU intrauterine using the IUI Catheter under guidanes of trans abdominal U/S in the cycle prior to the transfer cycle of frozen imperious .
group B : Include 30 infertile patients with previous filed ICSI and prepared for frozen embryoes transfere cycle , but not injected by GCSF (used as a control group)
Patients:
Patients included in the study attented to infertility center in gynecology department of Minia university (MIRU) in the period from march 2015 to march 2016.
Inclusion criteria :
1.Age : 20-35y
2. Average sized uterus without focal lesions (was previously evaluated by trans vaginal U/S)
3. Normal uterine cavity (was evaluated by Hysteroscopy)
4. Patients having grade I & grade II embryoes preserved.
5. No history of endocrinal disorder.
6. No Systymic disorder.
Exclusion criteria:
5. Patients less than 20 years, older than 35 years.
6. Patient with congenital anomalies in the uterus .
7. Patient with previous uterine surgery except C.S.
8. Patients with endometriosis.
Preparations of GCSF transfused group:
o GCSF injection was done on midluteal phase in cycle prior to the transfer cycle (to prevent any manipulation intrauterine disturbing the endometrial receptivity befor empryo transfer).
o The injection was done using the IUI catheter under guidanes of transabdomenal U/S (Mandry 6900 with frequency 7.00 MHz) by injection of 100IU of GCSF transcavitary under sterilized techniques.
Preparation of endometrium for embryo transfer
o In the 2nd day of the next cycle endometrium prepared by esterogen (Cycloprogenova, 2mg estradiol valerate white tablet 200mg) progesterone (Duphaston dydrogesterone (9beta, 10alpha - pregna-4,6-diene-3,20-dione) 10 mg.
o On the 7th day we repeated transevaginal U/S to measure endometrial thickness.
o Transevaginal U/S was repeated every 48h)
o Embryo transfer (2-4 embryoes ware transferred) was done on the 3rd of progesterone stimulation (for day 3 embryo) or in the 4th day of progesterone stimulation (for day 4 embryo) or in 5th progesterone stimulation (for blastocyst)
o Luteal phase support was done by progesterone (Duphaston dydrogesterone (9beta,10alpha-pregna-4,6-diene-3,20-dione) 10 mg.
o Pregnancy test was done after 2 weeks.
o Estimation of endometrial thickness just before embryo transfer by u/s.
o Embryo transfer was cancelled if endometriam thickness <7mm.
• Preparation of control group
o This group underwent the same steps as GCSF transfused group but with out intrauterine infusion of GCSF.
The primary outcome was: Endometrial thickness measurements and endometrial pattern
The secondary outcome was: the Chemical, clinical and ongoing pregnancy pregnancy rate.
The following parameters were calculated and recorded in the two groups throughout the procedures:
Age (years) , Type of infertility, Duration of infertility, Cause of infertility, Embryo grading , Endometrial thickness, Endometrial pattern and Chemical, clinical and ongoing pregnancy.
The base line parameters were compared between G-CSF co-treated group ( group A ) and control group (group B)
There were No significant difference in age , type of infertility , period of infertility , cause of infertility between two groups .
The number and quality of transferred embryos were similar in the two groups
The mean of endometrial thickness (in the 12th - 13th cycle day ) was greater in G-CSF co-treated group (group A). with statistical significance (0.004*) after injection of G-CSF intrauterine.
We found that GCSF has no effect on endometrial pattern between the two groups with no statistically significance ( p value 0.306) for further studies An improvement in chemical and clinical pregnancy rates was shown in G-CSF cotreated group ( group A ), with statistical significant (0.031*).