Use of granulocyte colony-stimulating factor in ART treatment does not increase the risk of adverse perinatal outcomes

Abstract

RESEARCH QUESTION: Granulocyte colony-stimulating factor (G-CSF) acts on reproductive function at different stages, but its effects on the early stages of embryo development are unknown. The aim of this study was to assess the effect of G-CSF administration during treatment with assisted reproductive technologies (ART) and early pregnancy on newborns. DESIGN: Retrospective study in women undergoing egg donation, with a study group including 33 live-born children from a pregnancy in which G-CSF was administered, and a control group of 3798 children in which this medication was not ordered during pregnancy. The analysis was of perinatal outcomes resulting from G-CSF treatment administered off-label compared with a control group. RESULTS: No significant differences were found in maternal age (40.9 +/- 0.1 versus 38.9 +/- 1.8, P=0.055), body mass index (23.2 +/- 0.2 versus 22.6 +/- 1.5, P=0.503), infant birthweight (2952 +/- 200 versus 3145 +/- 270 g, P=0.184), gestational age (38 +/- 1 versus 37 +/- 1 weeks, P=0.926) or length (50.2 +/- 1.5 versus 48.7 +/- 2.7 cm, P=0.678) (between the control group and women treated with G-CSF, respectively). The prematurity rates of births before week 36 (10.0% versus 9.5%, P=0.783) or week 32 (2.2% versus 0.0%, P=0.585) were similar in the control and study groups, respectively. The incidence of low birthweight (<2500 g; 19.6% versus 11.8%, P=0.570) or very low birthweight (1500 g; 2.5% versus 0.0%, P=0.454) was not significantly different between non-treated and G-CSF-treated women, respectively. CONCLUSIONS: Administration of G-CSF at embryo transfer and during early pregnancy in recurrent miscarriage patients with KIR-HLA-C mismatch undergoing egg donation ART treatment does not convey a higher risk of perinatal complications.