The role of granulocyte-macrophage colony-stimulating factor in female assisted reproductive technology treatment: a systematic review and meta-analysis.

The objective of this study is to explore the impact of the use of granulocyte-macrophage colony-stimulating factor (GM-CSF) in female undergoing assisted reproductive technology (ART) on reproductive outcomes. A literature search was performed using electronic databases (PubMed, EMBASE, Web of Science, CNKI, Wanfang data, Geen Medical, and Cochrane Library). Risk ratio (RR), odds ratio (OR), and mean difference (MD) with 95% confidence intervals (CI) for various outcomes were presented. The publication bias and heterogeneity were determined using funnel plot symmetry and I test separately. The combined results of the RCT studies did not reveal statistical differences between the GM-CSF group and the control group for any outcome indicators. However, our pooling of results showed that after meta-analysis of non-RCT studies, GM-CSF had a positive effect on implantation rate (OR 1.90; 95% CI 1.11-3.24), clinical pregnancy rate (OR 1.54; 95% CI 1.21-1.95), live birth rate (OR 1.43; 95% CI 1.04-1.98), and available embryo rate (OR 1.27; 95% CI 1.10-1.46). In conclusion, these results suggest that for a subset of women undergoing ART, GM-CSF may favorably affect CPR, LBR, IR, and available embryo rate (AER). TRIAL REGISTRATION: PROSPERO registration number CRD42022322778.