Clinical use of colony-stimulating factor-1 in ovulation induction for poor responders.
OBJECTIVE
To evaluate the benefit of colony-stimulating factor-1 (CSF-1) adjuvant therapy to poor responders during a controlled ovarian hyperstimulation (COH) cycle.


METHODS
Prospective clinical study.


METHODS
University hospital, general hospital, and private IVF clinic in Japan.


METHODS
Thirty normogonadotropic patients who did not respond to conventional COH protocols.


METHODS
Eight million units of recombinant human CSF-1 were administered IV every other day during ovarian stimulation using FSH or hMG to 30 normogonadotropic poor responders. Serum CSF-1 concentrations were assayed on day 3. Additional studies were performed in a private IVF clinic on 27 poor responders with low serum CSF-1 levels.


METHODS
Pregnancy rates (PR). In addition, number of mature follicles, cycle cancellations, amount of required gonadotropins were documented.


RESULTS
Significantly more mature follicles, fewer cycle cancellations, and lower amounts of required gonadotropins were seen in the group treated with CSF-1. Five (16.7%) pregnancies were achieved. The CSF-1-effective patients displayed significantly lower serum CSF-1 concentrations. In a private IVF clinic, CSF-1 treatment increased the number of mature oocytes, fertilized eggs, and transferred embryos. Cycle cancellations decreased from 18.5%-3.7%; 11 pregnancies (40.7%) resulted from treatment.


CONCLUSIONS
Concomitant administration of CSF-1 and hMG improved follicle developments, especially in patients with low serum CSF-1 levels in the early follicular phase.
Takasaki
Akihisa
A
Department of Obstetrics and Gynecology, Saiseikai Shimonoseki General Hospital, Shimonoseki, Yamaguchi, Japan.
Ohba
Takashi
T
Okamura
Yoshinori
Y
Honda
Ritsuo
R
Seki
Moritoshi
M
Tanaka
Nobuyuki
N
Okamura
Hitoshi
H
D000328:Adult; D004359:Drug Therapy, Combination; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000378:metabolism / Q000628:therapy*; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood / Q000627:therapeutic use*; D008596:Menotropins / Q000627:therapeutic use; D054315:Oocyte Retrieval; D010062:Ovulation Induction; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D005300:Fertility Agents, Female; D011994:Recombinant Proteins; D008596:Menotropins; D016173:Macrophage Colony-Stimulating Factor