Whether G-CSF administration has beneficial effect on the outcome after assisted reproductive technology? A systematic review and meta-analysis

Abstract

BackgroundPrevious studies have explored the effect of granulocyte colony stimulating factor (G-CSF) administration on the outcome of assisted reproductive technology (ART), and came into controversial conclusions. The present meta-analysis aims to assess whether G-CSF administration has beneficial effect on the outcome after ART.MethodThe electronic databases Pubmed, Embase and Google Scholar were searched up to May 2016. Articles that studied the effect of G-CSF administration on the outcome after ART were included in the present meta-analysis. Odds ratio (OR) with 95 % confidence interval (95 % CI) were calculated to assess the effect of G-CSF administration on the outcome after ART. The outcomes of interest were implantation rate (IR) and pregnancy rate (PR).ResultsFour cohort studies with 1101 embryos transplantation assessed the effect of G-CSF administration on IR and 6 studies with 621 cycles assessed the role of G-CSF administration in PR. Meta-analysis did not found an increased embryo IR in G-CSF administration cycles [OR 1.59 (95 % CI 0.74–3.41). whereas the PR with G-CSF administration was significantly higher compared with cases without G-CSF administration [OR 2.03 (95 % CI 1.19–3.46)]. Additionally, we found that G-CSF administrated subcutaneously resulted in significantly higher PR [OR 3.12 (95 % CI 1.67–5.81)] and IR [OR 2.82 (95 % CI 1.29–6.15)] compared with control group, whereas G-CSF administrated via local uterine infusion had no beneficial effect on the PR [OR 1.42 (95 % CI 0.91–2.24)] and IR [OR 1.10 (95 % CI 0.76–1.60)] after ART.ConclusionsG-CSF administration may have beneficial effect on clinical pregnancy outcome after ART. Subcutaneous injection may be an optimal route of G-CSF administration. Further cohort studies are required to explore the mechanisms undergone the effect and investigate the best route and dose of G-CSF administration.Electronic supplementary materialThe online version of this article (doi:10.1186/s12958-016-0197-2) contains supplementary material, which is available to authorized users.

The Effects of Subcutaneous Administration of Granulocyte Colony-Stimulating Factor on Pregnancy Outcome After Assisted Reproductive Technology: Clinical Trial

“…Conversely, some studies explained that G-CSF administrations have no effect on implantation or pregnancy rate (11,27,31). This can be due to several parameters such as small sample size, patient's age, as well as endometrial thickness, a low dose of G-CSF, and onetime G-CSF administration (32).…”

“…Little information is available on the exact mechanism of G-CSF impact on endometrial thickness. It is proven that G-CSF receptors in the fetomaternal interface and endometrium are expressed and secreted by both fetal chorionic villous and maternal decidual tissues in the first trimester, indicating the important role of G-CSF in maintaining pregnancy (32,33).…”

Use of granulocyte-colony stimulating factor in assisted reproductive technology: A systematic review and meta-analysis

“…Zhao et al have published a systematic review and meta-analysis on the role of G-CSF supplementation in ART and included six studies [18]. They have reported a significantly higher pregnancy rate with the use of G-CSF (OR 2.03, 95 % CI 1.…”

Non-invasive intra-uterine administration of Botulinum Toxin A enhances endometrial angiogenesis and improves the rates of embryo implantation

“…Recent studies showing the increased expression levels of angiogenesis-related factor, VEGF, and its receptor in the late secretory and early pregnancy strongly suggest that the endometrial angiogenesis plays crucial roles in endometrial response to the implanting blastocyst, likely a key factor of endometrial vasculature in determining the endometrial receptivity [3,12]. Even though there are several trials to improve endometrial environment via inducing angiogenic effect with many kinds of substances including granulocyte colony-stimulating factor (G-CSF), mesenchymal stem cells (MSC), and platelet-rich plasma (PRP) [13][14][15], the e cacy of those substances is still controversial due to the lack of evidences [16][17][18].…”