Clinical Applications of Recombinant Human Granulocyte Colony-Stimulating Factor in Reproductive Medicine: Expert Consensus
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Abstract
Recombinant human granulocyte colony-stimulating factor (rhG-CSF) is primarily indicated for neutropenia caused by various etiologies in clinical practice. Recently, it has been shown to have some therapeutic effects and be safe for mother and child in some clinical research and treatment of reproductive diseases. However, until now, there is currently no authoritative expert consensus and guidelines published. To standardize the research and rational application of rhG-CSF in reproductive medicine-related fields, the Committee on Reproductive Immunity of the China Association for Promotion of 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, clinical research evidence, and the national situation of China. According to evidence-based data, recommendations were established on the applicable population, medication methods, and timing of discontinuation of rhG-CSF in reproductive medicine. It is recommended that rhG-CSF could be applied in 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 applied in unexplained RSA with the slow rise of human chorionic gonadotropin and embryo growth retardation. After the patient signs the super instruction for medication and treatment informed consent form, rhG-CSF can only be used for patients with thin endometrium, unexplained recurrent miscarriage, unexplained repeated embryo implantation failure, slow rise of human chorionic gonadotropin. Comprehensive communication between gynecologists and obstetricians and patients before therapy is essential according to that the rhG-CSF treatment would be inefficient when a genetic abnormality, embryo abnormality, heterotopic pregnancy and other unknown disorder exist.
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