{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:37:11Z","timestamp":1792100231337,"version":"4.4.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> This trial was designed to assess the treatment effects of granulocyte colony-stimulating factor (G-CSF) and transcutaneous electrical acupoint stimulation (TEAS) on thin endometrium in frozen-thawed embryo transfer (FET) cycles.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Ninety-nine patients with previous cancellations of embryo transfer were included, 56 of whom were prospectively treated with intrauterine perfusion of G-CSF in subsequent FET cycles. The selected patients were randomized into the G-CSF perfusion only group and the G-CSF perfusion combined with TEAS group. The other 43 patients were retrospectively included as controls.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Compared to previous cycles, endometrial thickness was statistically significantly increased in the two treatment groups (5.97 \u00b1 0.60, 7.52 \u00b1 0.56, 6.14 \u00b1 0.52, and 7.66 \u00b1 0.44; <jats:italic>P<\/jats:italic> = 0.00 and 0.00, respectively). The increases in endometrial thickness suggested that no statistically significant difference was found between the two treatment groups. The G-CSF with TEAS group suggested a higher embryo implantation rate than the G-CSF perfusion only and control groups (33.33 and 29.1% and 33.33 and 17.39%; <jats:italic>P<\/jats:italic> = 0.412 and 0.091, respectively). The G-CSF combined with TEAS group demonstrated nominally higher clinical and ongoing pregnancy rates than the G-CSF perfusion-only group and controls, though, the difference was not statistically significant.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> G-CSF has a potential role in improving endometrium thickness in patients with thin unresponsive endometrium in FET treatment cycles. In addition, when combined with TEAS, G-CSF perfusion treatment also improves the embryo implantation rate; however, randomized controlled trials are highly demanded to provide high-grade evidence regarding clinical pregnancy rate after G-CSF perfusion treatment.<\/jats:p>","DOI":"10.3389\/frph.2021.647336","type":"journal-article","created":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T05:39:55Z","timestamp":1625722795000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Granulocyte Colony-Stimulating Factor Combined With Transcutaneous Electrical Acupoint Stimulation in Treatment of Unresponsive Thin Endometrium in Frozen Embryo Transfer Cycles"],"prefix":"10.3389","volume":"3","author":[{"given":"Linjiang","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinxiu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaomi","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xudong","family":"Shan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.4103\/0974-1208.178632","article-title":"The endometrium in assisted reproductive technology: how thin is thin?","volume":"9","author":"Mahajan","year":"2016","journal-title":"J Hum Reprod Sci."},{"key":"B2","doi-asserted-by":"publisher","first-page":"409","DOI":"10.3109\/09513590.2014.906571","article-title":"Treating patients with thin endometrium - an ongoing challenge","volume":"30","author":"Lebovitz","year":"2014","journal-title":"Gynecol Endocrinol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1016\/j.rbmo.2019.09.008","article-title":"Use of granulocyte colony-stimulating factor in ART treatment does not increase the risk of adverse perinatal outcomes","volume":"39","author":"Cruz","year":"2019","journal-title":"Reprod Biomed Online."},{"key":"B4","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.cyto.2014.09.002","article-title":"Granulocyte colony-stimulating factor: a relation between serum and follicular fluid levels and in-vitro fertilization outcome in patients with polycystic ovary syndrome","volume":"74","author":"Kahyaoglu","year":"2015","journal-title":"Cytokine."},{"key":"B5","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1007\/s00005-012-0212-z","article-title":"Granulocyte-colony stimulating factor as treatment option in patients with recurrent miscarriage","volume":"61","author":"Santjohanser","year":"2013","journal-title":"Arch Immunol Ther Exp."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2703","DOI":"10.1093\/humrep\/dep240","article-title":"Use of granulocyte colonystimulating factor for the treatment of unexplained recurrent miscarriage: a randomised controlled trial","volume":"24","author":"Scarpellini","year":"2009","journal-title":"Hum Reprod."},{"key":"B7","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1093\/humrep\/des370","article-title":"A pilot cohort study of granulocyte colony-stimulating factor in the treatment of unresponsive thin endometrium resistant to standard therapies","volume":"28","author":"Gleicher","year":"2013","journal-title":"Hum Reprod."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2123","DOI":"10.1016\/j.fertnstert.2011.01.143","article-title":"Successful treatment of unresponsive thin endometrium","volume":"95","author":"Gleicher","year":"2011","journal-title":"Fertil Steril."},{"key":"B9","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1016\/j.fertnstert.2013.12.016","article-title":"A randomized clinical trial of endometrial perfusion with granulocyte colony-stimulating factor in in vitro fertilization cycles: impact on endometrial thickness and clinical pregnancy rates","volume":"101","author":"Barad","year":"2014","journal-title":"Fertil. 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