بررسی تأثیر تزریق داخل رحمی فاکتور محرک گرانولوسیت (G-CSF) بر میزان موفقیت تزریق داخل رحمی اسپرم

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی اردبیل، اردبیل، ایران.

2 پزشک عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی اردبیل، اردبیل، ایران.

3 دانشیار سیاست‌گذاری سلامت، مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشکده پزشکی، دانشگاه علوم پزشکی اردبیل، اردبیل، ایران.

چکیده

مقدمه: IUI یا تزریق اسپرم شسته شده به درون حفره‌ رحم، یکی از روش‌های کمک باروری می‌باشد که کاربرد بسیار گسترده‌ای در درمان ناباروری یافته است. مطالعه حاضر با هدف بررسی تأثیر تزریق داخل رحمی فاکتور محرک گرانولوسیت (G-CSF) بر میزان موفقیت IUI در بیماران مراجعه کننده به مرکز ناباروری دانشگاه علوم پزشکی اردبیل انجام گرفت.
روش‌کار: این مطالعه کارآزمایی بالینی در سال 99-1398 بر روی 100 زن نابارور با نازایی اولیه که جهت انجام IUI به مرکز ناباروری دانشگاه علوم پزشکی اردبیل مراجعه کردند، انجام شد. افراد به‌صورت کاملاً تصادفی به دو گروه 50 نفره مداخله و کنترل تقسیم شدند. جهت تحریک تخمک‌گذاری برای زنان هر دو گروه، کلومیفن سیترات از روز سوم تا پنجم قاعدگی با دوز 100-50 میلی‌گرم روزانه به‌مدت 5 روز و آمپول‌های گنادوتروپین با دوز 150 میلی‌گرم در روزهای 7 و 9 تجویز شده و بعد از حصول حداقل یک فولیکول با قطر 20 میلی‌متر یا بیشتر، آمپول HCG برای بلوغ نهایی اووسیت تزریق گردید. در گروه مداخله علاوه بر اقدامات قبلی در روز تزریق HCG، 100 میکروگرم G-CSF داخل رحم با کاتتر IUI تزریق و سپس 36 ساعت بعد عمل IUI انجام گرفت. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 25) انجام شدند. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: میزان موفقیت IUI بر اساس تست βHCG در گروه مورد 20% و در گروه شاهد 4% بود که بین دو گروه اختلاف آماری معنی­ داری در میزان بارداری موفق مشاهده گردید (028/0=p).
نتیجه ­گیری: نتایج این مطالعه نشان داد تجویز G-CSF در مقایسه با عدم درمان، شانس بارداری را بهبود می‌بخشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of intrauterine injection of granulocyte stimulating factor (G-CSF) on IUI success rate

نویسندگان [English]

  • Franak Jalilvand 1
  • Elham Mostafavi Rad 2
  • Fariba Kahnamouei 1
  • hamed zandian 3
  • shahla Farzipour 1
1 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
2 General Practitioner, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
3 Associate Professor of Health Policy, Social Determinants of Health Research Center, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.
چکیده [English]

Introduction: IUI or injection of washed sperm into the uterine cavity is one of the assisted reproductive techniques that has been widely used in the treatment of infertility. This study was performed with aim to evaluate the effect of intrauterine injection of granulocyte stimulating factor (G-CSF) on the success rate of IUI in patients referred to the infertility center of Ardabil University of Medical Sciences.
Methods: This clinical trial study was performed in 2019-2020 on 100 women with primary infertility referred to the Infertility Center of Ardabil University of Medical Sciences for IUI. The subjects were randomly divided into intervention and control groups each with 50 women. To stimulate ovulation for the women in two groups, clomiphene citrate was administered from the third to the fifth day of menstruation at a dose of 50-100 mg daily for five days and gonadotropin ampoules were administered with dose 150 mg at days 7 and 9 and after reaching to at least one follicle with 20 ml diameter, HCG was injected for the final maturation of the oocyte. In the intervention group, in addition to previous procedures on the day of HCG injection, 100 micrograms of G-CSF was injected intrauterine with IUI catheter, and then IUI was performed 36 hours later. Collected data were analyzed by SPSS (version 25). P<0.05 was considered significant.
Results: The success rate of IUI based on βHCG test was 20% in the case group and 4% in the control group, which showed a statistically significant difference in the success rate of pregnancy (p=0.028).
Conclusion: The results of the present study showed that G-CSF administration improves the chance of pregnancy compared to no treatment.

کلیدواژه‌ها [English]

  • Granulocyte stimulating factor
  • Infertility
  • Intrauterine sperm injection

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مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 10
دی 1402
صفحه 13-22

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