Granulocyte macrophage-colony stimulating factor production by autologous endometrial co-culture is associated with outcome for in vitro fertilization patients with a history of multiple implantation failures

PROBLEM: To determine whether granulocyte macrophage (GM)-colony stimulatin g factor (CSF) produced by autologous endometrial co-culture was associated with outcome in 53 patients with a history of multiple in vitro fertilizat ion failures. METHOD OF STUDY: The conditioned media from endometrial co-culture cells ex posed or non-exposed to human embryos was analyzed for GM-CSF. RESULTS: Exposure or non-exposure to an embryo did not result in an enhance ment of GM-CSF production. Insignificant levels of GM-CSF were determined f rom media alone. ROC analysis revealed that levels of GM-CSF from supernata nts of endometrial co-culture exposed to embryos that measured below 130 pg /ml reflected a diminished prognosis (5/17 had a positive pregnancy vs. 21/ 36 with GM-CSF levels greater than 130 pg/ml; P < 0.05). CONCLUSIONS: The improved outcome associated with GM-CSF values greater tha n 130 pg/ml may reflect: 1) a direct positive effect of GM-CSF; 2) an embry otrophic factor upregulated by GM-CSF; or, 3) that GM-CSF functions as a ma rker for the importance of the glandular component in endometrial co-cultur e systems.