g-csf (uterine flush)

Consent for Granulocyte Colony Stimulating Factor
I understand that granulocyte colony stimulating factor (G-CSF, filgrastim, Neupogen®) has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of patients undergoing therapy with strong chemotherapeutic medications in order to reduce the risk of infection related to a marked lowering of the white blood cell concentration. 

I have learned that more recently it has been used to treat women with thin uterine lining undergoing treatment for infertility (1, 2).  This group of women was not able to develop uterine lining approaching ideal thickness despite treatment with estrogen and a variety of other medications such as pentoxifylline, Vitamin E and sildenafil (Viagra), but did so when they received G-CSF.  Although the number of patients treated to date is small, I understand that in many there has been improvement in the endometrial thickness, that pregnancies have occurred, that healthy babies have been born and that no complications of treatment have been reported yet.    

I understand that the G-CSF is administered as a “uterine flush” on the day of egg recovery if the lining remains thin.  Treatment would be repeated again two days later if there has been no improvement.  

Although side effects have not been reported yet with the use of G-CSF for this purpose, the side effects which have been reported when used in conjunction with chemotherapy have included bone pain, allergic reactions, rashes, shortness of breath, wheezing, dizziness, swelling around the mouth or eyes, fast pulse, sweating, elevated white blood cell count, an increase in coagulability of the blood, changes in liver function tests and enlargement of the spleen. Women with sickle cell disorder may have a sickle cell crisis after getting G-CSF. 

I understand that medications approved by the FDA may be used for unapproved indications which are called “off-label”.  I request that California Fertility Partners administer G-CSF to me in an attempt to thicken my uterine lining and make it more receptive to embryo implantation.  I understand that the use of G-CSF to improve endometrial thickness is an “off-label” use of the medication. 


  1. Hello, my name is Alina, 36 years, one tube (ectopic pregnancy), Hashimoto's.
    I also made four hysteroscopy, my endo does not want to grow(~6-7 mm), with a tendency to cleave the walls ... I had an IUD inserted, dr. trying to keep the walls apart.
    Now under protocol(estrogen, vit. E, L-Arginina, Viagra, estrogen patch) for frozen embryo and got a 'wash' of the uterus with Neupogen ...
    Wait to see the results, I promise to communicate with you, no matter the outcome!

    1. Hi Alina, thank you so much for sharing your protocol. Wishing you a ton of luck on this cycle!! Please, please keep me updated!

  2. Suzanne, did this help at all for you?

    1. Hi Katie! I actually did not have it done. My p4 levels started to rise and it was too late for the procedure. They planned on doing it with my next cycle, but because of the amount of embryos we had, we declined and went with surrogacy. However, I still thought it was and important protocol that I have read people having success with and wanted the information available on my blog. www.dreamingofdiapers.com did do this protocol with her recent cycle. I think it did thicken somewhat afterwards, but her cycle was not successful. She did write about it, so I would definitely check out her thoughts. :)

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