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15.09.2018 | Review | Ausgabe 5/2018 Open Access

Archives of Gynecology and Obstetrics 5/2018

Therapeutic role of granulocyte colony-stimulating factor (G-CSF) for infertile women under in vitro fertilization and embryo transfer (IVF-ET) treatment: a meta-analysis

Zeitschrift:
Archives of Gynecology and Obstetrics > Ausgabe 5/2018
Autoren:
Ling Zhang, Wei-Hai Xu, Xiao-Hua Fu, Qiong-Xiao Huang, Xiao-Yan Guo, Lin Zhang, Shi-Shi Li, Jing Zhu, Jing Shu
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00404-018-4892-4) contains supplementary material, which is available to authorized users.
Joint first authors: Ling Zhang and Wei Hai Xu.

Abstract

Objective

The aim of this meta-analysis is to explore the beneficial role of granulocyte colony-stimulating factor (G-CSF) on infertile women under artificial reproduction technology treatment.

Method

Medline, Embase and ISI Web of Science databases were searched to identify relevant randomized control trials. Studies before July, 2017 were included for primary screening. Meta-analysis of the total and subgroup patients was conducted, and relative risks (RRs) and their 95% confidence intervals (95% CI) were calculated by a fixed-effect model if no heterogeneity (evaluated as I2 statistic) existed. Otherwise, a random-effects model was adopted. Subgroup analysis was performed by administrating route or clinical indication. Egger test and influence analysis were conducted to evaluate the publication bias and study power, respectively.

Results

The final selection enrolled 10 RCTs, involving 1016 IVF-ET cycles (521 distributed to the G-CSF group and 495 to the control). Compared with control group, G-CSF administration could significantly improve clinical pregnancy rate (CPR, RR 1.89, 95% CI 1.53–2.33), while it had no beneficial effect on embryo implantation rate (IR, RR 1.84, 95% CI 0.84–4.03). The subgroup analysis by administration route showed that both uterine infusion and subcutaneous injection can produce a substantial increase in CPR, with the pooled RRs (95% CI) 1.46 (1.04–2.05) and 2.23 (1.68–2.95), respectively. Nevertheless, most of included RCTs dealt with the RIF subjects, and the pooled analysis of this data showed a higher PR and IR in G-CSF group as compared to that in the control, with the RRs (95% CI) 2.07 (1.64–2.61) and 1.52 (1.08–2.14), respectively. Egger regression test did not demonstrate any significance for the publication bias.

Conclusion

G-CSF administration has a beneficial role on the clinical outcome after embryo transfer by both routes of local infusion and systematic administration, especially for the cases with RIF. Further RCTs are needed to investigate the role of G-CSF in thin endometrium patients.

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