title: Successful treatment of unresponsive thin endometrium.
abstract: OBJECTIVE
  To assess whether inadequate, thin endometrium (<7 mm), after failure to expand with standard treatment options, will be responsive to cytokine treatment.
  
  
  METHODS
  Prospective cohort study of four patients.
  
  
  METHODS
  Two independent IVF centers in New York City.
  
  
  METHODS
  Four consecutive women undergoing IVF who, after standard endometrial preparation, still demonstrated highly inadequate endometrium.
  
  
  METHODS
  Transvaginal endometrial perfusion with granulocyte colony-stimulating factor (G-CSF).
  
  
  METHODS
  Endometrial thickness on day of ET, with pregnancy as secondary endpoint.
  
  
  RESULTS
  We report successful endometrial expansion to at least minimal thickness of 7 mm after uterine perfusion with G-CSF in four patients previously resistant to treatment with estrogen and vasodilators. All four patients therefore reached ET, and all four also conceived, although one pregnancy required termination because of intramural, corneal ectopic location. Endometrial expansion to minimal thickness occurred within approximately 48 hours from infusion.
  
  
  CONCLUSIONS
  Uterine perfusion with G-CSF represents a promising new tool for the currently mostly intractable problem of inadequate, thin endometrium. This treatment also deserves further investigation for its potential to improve implantation chances in association with IVF and, therefore, pregnancy rates.
authors.affiliation: Center for Human Reproduction and the Foundation for Reproductive Medicine, New York, New York 10021, USA. ngleicher@thechr.com
authors.forename: Norbert
authors.initials: N
authors.lastname: Gleicher
authors.forename: Andrea
authors.initials: A
authors.lastname: Vidali
authors.forename: David H
authors.initials: DH
authors.lastname: Barad
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D004717:Endometrium / Q000187:drug effects / Q000473:pathology*; D005260:Female; D005307:Fertilization in Vitro; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009929:Organ Size; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D016179:Granulocyte Colony-Stimulating Factor