Tekrarlayan i̇mplantasyon başarisizliği hastalarinin endometriumunda granulosit koloni stimülasyon faktör reseptörü ve serviko-vajinal lavajinda granulosit koloni stimülasyon faktör düzeyinin prognostik önemi

Implantation is adhesion of embryo to desidua, burrowing through basal membrane and invasion into the stroma as part of a complex dialogue involving growth factors, hormones, adhesion molecules, extracellular matrix and prostoglandines between the endometrium and the embryo. Nowadays, the most succesfull method between assisted reproductive techniques is intra-cytoplasmic sperm enjection (ICSI). With this instrument despite the %80 fertilisation rate is achievable, average live birth rate isn't more then %45. At this point, implantation failure and the endometrial receptivity are the rate limiting steps of Assisted Reproductive Techniques. G-CSF is an outstanding factor which is determining the endometrial receptivity, produced at the implantation period from fetomaternal place, placenta, desidua and cervico-vaginal secretions. Our goal with this study is to show the relationship between the pregnancy rate and G-CSF level at the cervico-vaginal lavage sample at the day of implantation, also G-CSF-R expression which is gained from endometrial biopsy at the patients who is suffering from recurrent implantation failure and scheduled for ICSI. We transcluded 19 patient to our study who is reffered to our University of Başkent, department of Gynecology and Oncology IVF clinic for ICSI at last 12 month. But we excluded the patients from the study whose age between 18-42 years, patients for thaw cycles or underwent mandatory single embriyo transfers. The samples were collected in the embriyo transfer (ET) day, with a minimal invasive procedure, from the servico-vaginal flushings and assesed in the biochemistry laboratory for G-CSF levels by ELISA (Enzyme Linked Immunosorbent Assay) method. G-CSF receptors are examined at the endometrial biopsy samples. A clinical retrospective research has done by the statistical investigation of relationship between the G-CSF ligand, G-CSF receptor levels and the pregnancy rate. There is no significant difference for p<0,05 confidence interval between G-CSF level, which is assessed from cervico-vaginal flushings at the day of embryo transfer, and patients, who has or hasn't gestasional sacs and fetal heart beat at the ultrasonography. There is no livery painting of the G-CSF receptors at the glandular areas of the endometrial biopsy samples. At 2 patients with β-hCG positive and 1 patient who is β-hCG negative, G-CSF receptor painting intensity was middle level at low diffusiveness cells which are in the stromal areas. To evaluate the clinical pregnancy rate with the G-CSF level, which is measured at the cervico-vaginal flushings, it is necessary to examine more patients. The importance of G-CSF for the fertilisation and the implantation will be understand better while the researches about it increase. Thus both will be possible to develop new treatment methods for the infertile couples and the new contraception techniques will appear for fertile couples.