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This analysis includes a subgroup of 422 subjects with either single-embryo transfer (SET, <jats:italic>N<\/jats:italic>\u2009=\u2009286) or double-embryo transfer of two embryos with equivalent morphological quality (DET, <jats:italic>N<\/jats:italic>\u2009=\u2009136). Implantation rate and live birth rate were assessed according to category of morphological embryo quality on day 3.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Culture with GM-CSF did not increase the implantation rate for embryos classified as poor quality. A trend towards greater benefit of GM-CSF on implantation and survival until live birth for top-quality embryos (TQEs) compared with poor-quality embryos was observed, although not statistically significant. For TQEs, the percentage of transferred embryos resulting in a live born baby was: 40.9\u2009\u00b1\u20095.3% (GM-CSF) versus 30.5\u2009\u00b1\u20094.6% (control) (<jats:italic>P<\/jats:italic>\u2009=\u20090.24; odds ratio [OR] 1.43, 95% confidence interval [CI] 0.79\u20132.59), and for embryos with less than 6 cells at day 3 this same rate was: 7.4\u2009\u00b1\u20093.3% (GM-CSF) versus 12.0\u2009\u00b1\u20094.0% (control) (<jats:italic>P<\/jats:italic>\u2009=\u20090.26; OR 0.53, 95% CI 0.17\u20131.61).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>This exploratory analysis is consistent with GM-CSF protecting morphologically normal embryos from culture-induced stress and does not support an effect of GM-CSF in rescuing poor-quality embryos.<\/jats:p>\n<jats:p>ClinicalTrials.gov identifier: NCT00565747.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s00404-020-05532-3","type":"journal-article","created":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T13:02:50Z","timestamp":1586437370000},"page":"1341-1346","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["GM-CSF does not rescue poor-quality embryos: secondary analysis of a randomized controlled trial"],"prefix":"10.1007","volume":"301","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4378-6181","authenticated-orcid":false,"given":"Kenny A.","family":"Rodriguez-Wallberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bibi","family":"Munding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00f8ren","family":"Ziebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9907-9289","authenticated-orcid":false,"given":"Sarah A.","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,4,9]]},"reference":[{"key":"5532_CR1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1242\/dev.107.3.597","volume":"107","author":"K Hardy","year":"1989","unstructured":"Hardy K, Handyside AH, Winston RML (1989) The human blastocyst: cell number, death and allocation during late preimplantation development in vitro. 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Rodriguez-Wallberg has no potential conflict of interest to disclose. Bibi Munding is employed by CooperSurgical, ORIGIO a\/s. S\u00f8ren Ziebe has no potential conflict of interest to disclose. Sarah A. Robertson is inventor on a patent describing use of GM-CSF in human reproductive medicine, previously licensed to CooperSurgical, ORIGIO a\/s.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by regional Ethics Committees and was in accordance with the principles of Helsinki Declaration II.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}