Clinical Applications of Recombinant Human Granulocyte Colony-Stimulating Factor in Reproductive Medicine: Expert Consensus

Abstract

The primary clinical indication for recombinant human granulocyte-stimulating factor (rhG-CSF) is neutropenia of multiple etiologies. In recent years, rhG-CSF has been proved to be effective and safe for mothers and fetus in the clinical application in some reproductive disorders. Until recently, there has been no reliable evidence of authoritative expert consensus or standards. In order to regulate the research and rational application of rhG-CSF in the fields of reproductive medicine, the Committee on Reproductive Immunity of the China Society for the Promotion of Human Health Science and Technology (the Committee) organized experts from relevant disciplines to formulate the Expert Consensus, which is based on the latest international basic study and clinical research evidence. According to evidence-based data, recommendations were established on the applicable population, starting method, and duration of rhG-CSF administration in reproductive medicine. It is recommended that rhG-CSF could be applicated in the patients with thin endometrium which was ineffective to standard treatments, in unexplained recurrent spontaneous abortion (RSA), in unexplained recurrent implantation failure (RIF), and could attempt to be applicated in unexplained RSA with slow rise of human chorionic gonadotropin and/or embryo growth retardation. Meanwhile, the patients are demand of ineffective to the standard therapy and need to sign informed consent for the off-label use of rhG-CSF before treatment. Comprehensive communication between OB/GYN and patients before therapy is essential according to that the rhG-CSF treatment would be inefficient when genetic abnormality, gamete damage, heterotopic pregnancy and other unknown disorder exist.