Comparative efficacy of granulocyte colony stimulating factor and platelet-rich plasma on clinical pregnancy rates and endometrial outcomes in women undergoing frozen embryo transfer: a randomized controlled trial with 560 subjects

Objective. Previous studies comparing granulocyte co­lo­ny stimulating factor (GCSF) and platelet-rich plasma (PRP) in the context of frozen embryo transfer (FET) have yiel­ded inconsistent results, largely due to a lack of robust ran­do­mized controlled trials (RCTs). This study aimed to assess the impact of intrauterine infusion of GCSF and PRP on cli­ni­cal pregnancy rates and other reproductive outcomes in women undergoing FET, and to evaluate their effects on implantation rates and endometrial characteristics. Materials and method. This RCT included 560 women who were randomly assigned to receive 300 mcg GCSF, 1 ml PRP, or saline as a control. The intervention was administered into the uterine cavity via an intrauterine insemination ca­the­ter under ultrasound guidance. All participants un­der­went conventional hormonal therapy before the FET cycle. Endometrial evaluation was conducted using trans­va­gi­nal ultrasound (TVUS), Doppler studies, and his­to­lo­gi­cal assessments in both natural and intervention cycles. Embryos were genetically tested prior to transfer. Results. The clinical pregnancy rates were similar across all groups (50.4% for GCSF, 51.2% for PRP, and 45.8% for saline; p=0.66). PRP administration significantly improved en­do­me­trial vascularity compared to saline (p=0.003); however, this did not translate into a higher clinical pregnancy rate. Live birth rates were also comparable among the groups (72.5% for GCSF and 75.6% for PRP). Conclusions. The study revealed that neither GCSF nor PRP influenced cli­ni­cal preg­nan­cy rates or overall pregnancy outcomes in wo­men un­der­go­ing FET. While PRP improved endometrial vas­cu­la­rity, it did not affect the clinical pregnancy rates. Both in­ter­ven­tions produced similar results to those using saline.