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.
Highlights
Previous 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
Four cohort studies with 1101 embryos transplantation assessed the effect of G-CSF administration on implantation rate (IR) and 6 studies with 621 cycles assessed the role of G-CSF administration in pregnancy rate (PR)
Meta-analysis did not found an increased embryo IR in G-CSF administration cycles [Odds ratio (OR) 1.59. whereas the PR with G-CSF administration was significantly higher compared with cases without G-CSF administration [OR 2.03]
Summary
Previous 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. Many therapies have been attempt to enhance the endometrial thickness and improve the endometrial receptivity, such as extending estrogen administration [9], low-dose aspirin [10], combination pentoxifylline and tocopherol [11], vaginal sildenafil citrate [12], and stem cells treatment [13, 14]. These treatments have improved endometrial receptivity and increased implantation and pregnancy rate in ART cycles in some extent.
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