Received February 23, 2021
Accepted October 29, 2021

Background: Recurrent implantation failure is defined as failure to achieve clinical pregnancy after the transfer of four or more good-quality embryos in a minimum of three fresh or frozen cycles in a woman under 40 years. Aim: To compare between the effect of intrauterine G-CSF, hCG and saline injection (as placebo) at the day of ovum pick-up on clinical pregnancy, chemical pregnancy, implantation and miscarriages rates in patient with recurrent implantation failure undergoing IVF/ICSI. Methodology: A Prospective double blinded parallel randomized controlled trial including 150 patients equally divided into 3 groups each containing 50 Group 1: Received intrauterine injection of G-CSF, Group 2: received intrauterine injection of 500 IU of hCG and Group 3: Received intrauterine injection of saline as placebo. The primary outcome measure is clinical pregnancy rate. Secondary outcomes are biochemical pregnancy, implantation and miscarriage rates. Results: Clinical pregnancy, biochemical pregnancy and implantation rates are highest in G-CSF group and lowest in saline group, while miscarriage rate wasn’t significantly different between all groups. Conclusion: Intrauterine administration of G-CSF at a dose of 100 mcg/1.0 c.c. at the time of ovum pick-up is associated with higher clinical pregnancy, chemical pregnancy and implantation rate as compared intrauterine saline administration. Further studies are needed to determine the optimum timing of intrauterine administration of G-CSF that achieves the best results, and longer follow-up is needed to determine the percentage of take home baby.