Objective  To investigate the effects of granulocyte colony-stimulating factor (G-CSF) combined with tadalafil (TD) on endometrial receptivity and pregnancy outcomes in patients with thin endometrium (TE).

Methods  Patients with TE in the department of reproductive medicine of the First Hospital of Qinhuangdao from May 2020 to March 2023 were selected as the study subjects. They were divided into a experimental group (G-GSF combined with TD) and a control group (G-GSF) according to the different treatment regimens. The endometrial receptivity [endometrial thickness (EMT), endometrial volume (EMV), endometrial blood flow peak systolic flow rate/end diastolic flow rate (EBF-S/D), endometrial fractionation, endometrial blood flow fractionation, uterine artery pulsatility index (AUPI), uterine artery resistance index (AURI) and uterine arterial peak systolic flow rate/end diastolic flow rate (AU-S/D)] of the TE patients before and after treatment (the endometrial transition day) were compared; the endometrial receptivity on endometrial transformation day, post-treatment pregnancy outcomes [embryo implantation rate (EIR), clinical pregnancy rate (CPR), and early miscarriage rate (ABR)], and the incidence of adverse reactions during treatment were compared between the two groups.

Results  A total of 60 patients were included in the study, with 30 in each group. Before treatment, the difference in endometrial receptivity between the two groups was not statistically significant (P>0.05). Compared with the pre-treatment period, the EMT, EMV, the proportion of type A endometrium and the proportion of type II+III endometrial blood flow significantly increased in the two groups after treatment on the endometrial transformation day increased significantly (P<0.05), while the EBF-S/D, AUPI, AURI and AU-S/D significantly decreased (P<0.05). EMT and EMV were greater in the experimental group than in the control group (P<0.05), whereas EBF-S/D, AUPI, AURI and AU-S/D were less than those in the control group (P<0.05). Compared with the control group, the differences in the proportion of endometrium, the proportion of endometrial blood flow, EIR, CPR and ABR in the experimental group were not statistically significant (P>0.05). No adverse reactions occurred during treatment in both groups.

Conclusion  G-CSF combined with TD can improve endometrial receptivity in TE patients with high safety, but there is no effect on pregnancy outcome.

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