Zhang Biyun, Xu Jianying, Wei Xiangcai, Zhong Xingming
Reproductive Immunization Center, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), NHC Key Laboratory of Male Reproduction and Genetics, Guangzhou, Guangdong, 510660, China.
Center of Reproductive Medicine, Zhuhai Center for Maternal and Child Health Care, Zhuhai, Guangdong, 519000, China.
Reprod Sci. 2025 May;32(5):1379-1387. doi: 10.1007/s43032-024-01736-z. Epub 2024 Dec 2.
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.
粒细胞集落刺激因子（G-CSF）是一种关键的造血细胞因子，其增强胚胎着床和提高子宫内膜容受性的潜力已受到关注。本荟萃分析旨在评估G-CSF在降低复发性流产发生率方面的治疗效果，从而丰富支持其在治疗方案中应用的临床证据。我们于2024年8月25日完成了全面的文献检索，涵盖了多个数据库，包括PubMed、Medline、Cochrane图书馆、科学网、临床试验、中国知网、维普和万方，以识别和分析评估G-CSF对复发性流产影响的随机对照试验（RCT）。我们的综述纳入了7项RCT。G-CSF的应用与流产率显著降低相关[RR = 0.48，95%CI（0.27，0.86），P = 0.01]。亚组分析表明，子宫内输注G-CSF在降低流产率方面特别有效（RR = 0.35，95%CI（0.18，0.68），P = 0.002），而皮下给药未显示出显著影响（RR = 0.55，95%CI（0.26，1.20），P = 0.13）。此外，在排卵期给予G-CSF被确定为在降低流产率方面特别有效（RR = 0.33，95%CI（0.18，0.63），P < 0.001）。对于有复发性流产病史的患者，子宫内给予G-CSF，尤其是在排卵期，与流产风险显著降低和成功妊娠结局可能性增加相关。这些发现凸显了G-CSF在这种医疗情况下作为一种有价值的治疗干预措施的前景。
