Granulocyte-colony stimulating factor administration for subfertile women undergoing assisted reproduction

Kamath, Mohan S; Kirubakaran, Richard; Sunkara, Sesh Kamal

doi:10.1002/14651858.cd013226.pub2

Cited by 29 publications

(20 citation statements)

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“…However, neither the clinical pregnancy rate nor the live birth rate increased in an RCT including 157 RIF patients reported by Kalem [ 17 ]. Recently, in a meta-analysis that included 1253 infertile women, Kamath et al reported no difference between the G-CSF group and the control group [ 18 ]. However, their target population was all infertile women undergoing ART instead of only RIF patients.…”

Section: Introductionmentioning

confidence: 99%

What is the impact of granulocyte colony-stimulating factor (G-CSF) in subcutaneous injection or intrauterine infusion and during both the fresh and frozen embryo transfer cycles on recurrent implantation failure: a systematic review and meta-analysis?

Hou

Jiang

Yang

et al. 2021

Reprod Biol Endocrinol

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Background Among recurrent implantation failure (RIF) patients, the rate of successful implantation remains relatively low due to the complex etiology of the condition, including maternal, embryo and immune factors. Effective treatments are urgently needed to improve the outcomes of embryo transfer for RIF patients. In recent years, many researchers have focused on immunotherapy using granulocyte colony-stimulating factor (G-CSF) to regulate the immune environment. However, the study of the G-CSF for RIF patients has reached conflicting conclusions. The aim of this systematic review and meta-analysis was performed to further explore the effects of G-CSF according to embryo transfer cycle (fresh or frozen) and administration route (subcutaneous injection or intrauterine infusion) among RIF patients. Method The PubMed, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for literature published from the initial to October 2020. The meta-analysis, random-effects model and heterogeneity of the studies with I2 index were analyzed. Stata 15 was used for statistical analysis. Results A total of 684 studies were obtained through the databases mentioned above. Nine RCTs included 976 RIF patients were enrolled in this meta-analysis. Subgroup analysis indicated that G-CSF improved the clinical pregnancy rate for both the fresh and frozen embryo transfer cycles (fresh RR: 1.74, 95% CI: 1.27–2.37, I2 = 0.0%, n = 410; frozen RR: 1.44, 95% CI: 1.14–1.81, I2 = 0.0.%, n = 366), and for both subcutaneous injection and intrauterine infusion (subcutaneous RR: 1.73, 95% CI: 1.33–2.23, I2 = 0.0%, n = 497; intrauterine RR: 1.39, 95% CI: 1.09–1.78, I2 = 0.0%, n = 479), but the biochemical pregnancy rate of the RIF group was also higher than that of the control group (RR: 1.85, 95% CI: 1.28–2.68; I2 = 20.1%, n = 469). There were no significant differences in the miscarriage rate (RR: 1.13, 95% CI: 0.25–5.21: I2 = 63.2%, n = 472) and live birth rate (RR: 1.43, 95% CI: 0.86–2.36; I2 = 52.5%; n = 372) when a random-effects model was employed. Conclusion The administration of G-CSF via either subcutaneous injection or intrauterine infusion and during both the fresh and frozen embryo transfer cycles for RIF patients can improve the clinical pregnancy rate. However, whether G-CSF is effective in improving livebirth rates of RIF patients is still uncertain, continued research on the utilization and effectiveness of G-CSF is recommended before G-CSF can be considered mainstream treatment for RIF patients.

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Section: Introductionmentioning

confidence: 99%

What is the impact of granulocyte colony-stimulating factor (G-CSF) in subcutaneous injection or intrauterine infusion and during both the fresh and frozen embryo transfer cycles on recurrent implantation failure: a systematic review and meta-analysis?

Hou

Jiang

Yang

et al. 2021

Reprod Biol Endocrinol

View full text Add to dashboard Cite

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“…So far 10 randomized controlled trials have been published (Barad et al, 2014;Aleyasin et al, 2016;Davari-Tanha et al, 2016;Eftekhar et al, 2016a,b;Sarvi et al, 2017;Arefi et al, 2018;Bakirarar et al, 2018;Huang et al, 2020a;Kalem et al, 2020), with conflicting results, followed by meta-analyses in a timely manner (presented in Table 5). The six meta-analyses published present rather supportive results (Zhao et al, 2016;Kamath et al, 2017;Li et al, 2017a;Hou et al, 2018;Jiang et al, 2020;Kamath et al, 2020). However, most of the meta-analyses have included both randomized controlled trials and non-randomized trials, weakening the level of evidence.…”

Section: Granulocyte Colony Stimulating Factor (G-csf)mentioning

confidence: 97%

“…However, most of the meta-analyses have included both randomized controlled trials and non-randomized trials, weakening the level of evidence. The most powered meta-analysis at the moment is a Cochrane review including 15 randomized control trials with 1,253 participants ( Kamath et al, 2020 ). The authors have shown a weak positive impact of G-CSF in reproductive outcomes, advising caution due to low quality data and increased uncertainty.…”

Section: Approaches To Improve Endometrial Receptivity In Unexplainedmentioning

confidence: 99%

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Approaches to Improve Endometrial Receptivity in Case of Repeated Implantation Failures

Makrigiannakis

Makrygiannakis

Vrekoussis

2021

Front. Cell Dev. Biol.

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Repeated implantation failures are a constant challenge in reproductive medicine with a significant impact both on health providers and on infertile couples. Several approaches have been proposed so far as effective; however, accumulative data have clarified that most of the treatment options do not have the evidence base for a generalized application to be suggested by the relevant societies. Implantation failures are attributed to either poor quality embryos or to defected endometrial receptivity. The current review aims to summarize in a systematic way all the new trends in managing RIF via interference with endometrial receptivity. The authors focus mainly, but not exclusively, on endometrial injury prior to embryo transfer and endometrial priming with autologous cells or biological agents. To this direction, a systematic search of the Pubmed database has been conducted taking into account the emerged evidence of the last two decades. All the suggested interventions are herein presented and analyzed in terms of reproductive outcomes. It is evident that properly powered and designed randomized trials are needed to support a new standard approach in RIF treatment that will safely be incorporated in national and international guidelines.

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“…Granulocyte colony-stimulating factor (G-CSF) is secreted by multiple cells including macrophages ( 67 , 68 ) and placental villous trophoblasts ( 69 ). Increasing evidence demonstrates the therapeutic effect of G-CSF in RSA, repeated implantation failure, luteinized unruptured follicle syndrome and women with thin endometrium ( 70 – 72 ). Previously, by using a co-cultured model, our study showed that trophoblasts-derived IL-6 promoted M2 macrophage polarization ( 73 ), which in turn induced the epithelial-mesenchymal transition of trophoblasts, thereby promoting migration and invasion though secreting G-CSF to activate PI3K/AKT/Erk1/2 signaling pathway ( 68 ).…”

Section: Crosstalk Between Trophoblasts and Macrophages At The Maternal-fetal Interfacementioning

confidence: 99%

Crosstalk Between Trophoblast and Macrophage at the Maternal-Fetal Interface: Current Status and Future Perspectives

et al. 2021

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The immune tolerance microenvironment is crucial for the establishment and maintenance of pregnancy at the maternal-fetal interface. The maternal-fetal interface is a complex system containing various cells, including lymphocytes, decidual stromal cells, and trophoblasts. Macrophages are the second-largest leukocytes at the maternal-fetal interface, which has been demonstrated to play essential roles in remodeling spiral arteries, maintaining maternal-fetal immune tolerance, and regulating trophoblast’s biological behaviors. Many researchers, including us, have conducted a series of studies on the crosstalk between macrophages and trophoblasts at the maternal-fetal interface: on the one hand, macrophages can affect the invasion and migration of trophoblasts; on the other hand, trophoblasts can regulate macrophage polarization and influence the state of the maternal-fetal immune microenvironment. In this review, we systemically introduce the functions of macrophages and trophoblasts and the cell-cell interaction between them for the establishment and maintenance of pregnancy. Advances in this area will further accelerate the basic research and clinical translation of reproductive medicine.

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Granulocyte-colony stimulating factor administration for subfertile women undergoing assisted reproduction

Abstract: Granulocyte-colony stimulating factor administration for subfertile women undergoing assisted reproduction.

Cited by 29 publications

References 50 publications

What is the impact of granulocyte colony-stimulating factor (G-CSF) in subcutaneous injection or intrauterine infusion and during both the fresh and frozen embryo transfer cycles on recurrent implantation failure: a systematic review and meta-analysis?

What is the impact of granulocyte colony-stimulating factor (G-CSF) in subcutaneous injection or intrauterine infusion and during both the fresh and frozen embryo transfer cycles on recurrent implantation failure: a systematic review and meta-analysis?

Approaches to Improve Endometrial Receptivity in Case of Repeated Implantation Failures

Crosstalk Between Trophoblast and Macrophage at the Maternal-Fetal Interface: Current Status and Future Perspectives

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