Efficacy of Granulocyte Colony Stimulating Factor in Reducing First Trimester Miscarriages in Women With a History of Recurrent Pregnancy Loss: A Systematic Review and Meta‐Analysis

Purpose Several studies have evaluated a wide range of immunomodulatory therapies for treatment of unexplained recurrent pregnancy loss (RPL) and granulocyte colony stimulating factor (G‐CSF) is a new addition. We aimed to perform a cumulative meta‐analysis to update and reevaluate the efficacy of the use of G‐CSF to reduce the risk of first trimester miscarriages in women with a history of RPL. Methods We searched electronic databases until September 26, 2024. We screened 309 citations and included six randomized control trials (RCTs) and four observational cohort studies. A total of 800 women were included in the analysis for the primary outcome; 426 (53%) women had treatment with G‐CSF and 374 (47%) women had placebo or no treatment. Results Women who were administered GCSF in early pregnancy had a statistically significant reduction in miscarriage compared to those who had placebo or no treatment, odds ratio [95% CI] = 0.4 [0.3; 0.7]. A subsequent significant increase in live birth was also found in women who had GCSF, odds ratio [95% CI] = 2.3 [1.4; 3.6]. Conclusion Among women with a history of recurrent pregnancy loss, administration of granulocyte colony stimulating factor resulted in statistically significant reduction in first trimester miscarriage and subsequent improvement in live birth.