Efficacy of granulocyte colony-stimulating factor for infertility undergoing IVF: a systematic review and meta-analysis

Abstract

Objective This study aimed to evaluate the effectiveness of granulocyte colony-stimulating factor (G-CSF) for infertility and recurrent spontaneous abortion. Methods Existing research was searched in PubMed, Embase and Cochrane Library till Dec 2021. Randomized control trials (RCTs) that compared G-CSF administration with the control group in infertility women undergoing IVF were included. The primary outcomes included clinical pregnancy rate; the secondary outcomes included live birth rate, abortion ratebiochemical pregnancy rate, embryo implantation rate, as well as endometrial thickness. Result(s) 20 RCTs were included in this study. G-CSF increased the clinical pregnancy rate (RR = 1.85; 95% CI: 1.07, 3.18) and the endometrial thickness (MD = 2.25; 95% CI: 1.58,2.92;) in patients with thin endometrium undergoing IVF. G-CSF increased the biochemical pregnancy rate (RR = 2.12; 95% CI: 1.54, 2.93), the embryo implantation rate (RR = 2.51; 95% CI: 1.82, 3.47) and the clinical pregnancy rate (RR = 1.93; 95% CI: 1.63, 2.29) in patients with a history of repeated implantation failure undergoing IVF. No differences were found in pregnancy outcomes of general IVF patients. Conclusions Granulocyte colony-stimulating factor is likely to be a potential option for infertility women undergoing IVF with thin endometrium or recurrent implantation failure . Trial registration Retrospectively registered (The PROSPERO registration number: CRD42022360161).

Uterine infusion strategies for infertile patients with recurrent implantation failure: a systematic review and network meta-analysis

“…But Pourmoghadam, Z. et al also found that the miscarriage rate was significantly decreased in the PBMC-treated group than the non-treated group, which did not reach significance in our study [ 16 ]. A meta-analysis consisting of 20 RCTs found that G-CSF increased the biochemical pregnancy rate, embryo implantation rate, and clinical pregnancy rate [ 81 ]. Another meta-analysis found G-CSF administration may improve clinical pregnancy rate, but it concluded that they were uncertain whether the administration of G-CSF improves ongoing pregnancy or overall clinical pregnancy rates or reduces miscarriage rate compared to no treatment or placebo for the included studies had unclear allocation concealment or were at high risk of performance bias [ 18 ].…”

Evaluation of the Effect of an Amniotic Membrane Derived Bio-Nano Product (LifeCell) on Human Endometrial Cells Proliferation and Gene Expression: An in-vitro Study

“…Another potential intervention is the use of granulocyte colony stimulating factor (GCSF), which has shown promise in improving endometrial thickness and pregnancy outcomes in cases of thin endometrium and recurrent implantation failure (RIF) but not in general population [24]. However, more research, including randomized controlled trials, is needed to establish its e cacy and determine the appropriate patient population for GCSF therapy.…”

Immune Cell Functionality during Decidualization and Potential Clinical Application

“…G-CSF is a strong inhibitor of cytotoxic NK cell function [ 268 ], which is necessary for the uterine receptive milieu. The success of G-CSF in increasing pregnancy rate has been reviewed in detail (i.a., in [ 267 , 269 , 270 ]). Although not all studies found an improving effect of intrauterine perfusion of G-CSF [ 271 , 272 , 273 ].…”

“…Recurrent implantation failure Thin endometrial lining Scratching [171][172][173][174][175][176][177][178], PRP infusion [183][184][185][186][187][188], G-CSF [267,269,270] Wound-healing-like Decidualization, Regeneration…”