The Role of Granulocyte Colony Stimulating Factor in Mitigating the Risk of Recurrent Miscarriages: A Comprehensive Review and Meta-Analysis

Abstract

Granulocyte colony-stimulating factor (G-CSF), a pivotal hematopoietic cytokine, has been noted for its potential to bolster embryo implantation and augment endometrial receptivity. The present meta-analysis endeavors to evaluate the therapeutic efficacy of G-CSF in mitigating the incidence of recurrent miscarriages, thereby enriching the clinical evidence supporting its use in treatment protocols. Our exhaustive literature search, concluded on August 25, 2024, spanned across various databases including PubMed, Medline, Cochrane Library, Web of Science, ClinicalTrials, China National Knowledge Infrastructure (CNKI), Weipu, and Wanfang, to identify and analyze randomized controlled trials (RCTs) that assessed the impact of G-CSF on recurrent miscarriage. Our review incorporated 7 RCTs. The application of G-CSF was linked to a marked reduction in the rate of miscarriage [RR = 0.48, 95% CI (0.27, 0.86), P = 0.01]. Subgroup analysis indicated that the intra-uterine infusion of G-CSF was notably effective in diminishing the miscarriage rate (RR = 0.35, 95% CI (0.18, 0.68), P = 0.002), while subcutaneous administration did not exhibit a significant impact (RR = 0.55, 95% CI (0.26, 1.20), P = 0.13). Moreover, the administration of G-CSF during the ovulatory phase was identified as particularly efficacious in reducing the miscarriage rate (RR = 0.33, 95% CI (0.18, 0.63), P < 0.001). Intrauterine administration of G-CSF, particularly during the ovulatory phase, is associated with a significant decrease in miscarriage risk and an enhancement in the likelihood of a successful pregnancy outcome in patients with a history of recurrent miscarriages. These findings highlight G-CSF’s promise as a valuable therapeutic intervention in this medical scenario.