Background
ovarian stroma, fibrosis
DIMINISHED OVARIAN RESERVE, DEGENERATION, FIBROSIS
Ten years ago, we treated repeated implantation failure in 10 women with diminished ovarian reserve by administering granulocyte colony-stimulating factor (G-CSF) in association with embryo transfers (ET), based upon previous reports [In diabetic rats, administration of G-CSF consistently decreased ovarian follicular degeneration as well as degeneration and fibrosis of ovarian stroma, while increasing serum anti-Müllerian hormone (AMH) concentrations [Considering our experience with the 3 patients and these G-CSF effects in animal models, we designed the present prospective randomized clinical trial examining whether G-CSF administration in the early luteal phases of each of 2 cycles (G-CSF priming) preceding the cycle involving assisted reproductive technology (ART) improved embryonic development and pregnancy rate following ART in patients with poor ovarian reserve, as well as whether priming increased serum AMH concentrations. We also investigated associations between effects of G-CSF priming and killer-cell immunoglobulin-like receptor (KIR) types, since some types have been associated with improved implantation following G-CSF administration on the day of ET [