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Debate: Should Filgrastim Be Used for Recurrent Pregnancy Loss? No
Book chapter

Debate: Should Filgrastim Be Used for Recurrent Pregnancy Loss? No

Abey Eapen
Recurrent Pregnancy Loss: Causes, Controversies and Treatment, Fourth Edition, pp.329-335
Taylor & Francis Group, Fourth edition
2025
DOI: 10.1201/9781003508144-38

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Abstract

Disruptions in immune-mediated mechanisms at the maternal–fetal interface are thought to contribute to recurrent pregnancy losses (RPLs). The concept of Reproductive Immunology and the use of immunomodulatory therapy has gathered significant interest within the field of reproductive medicine in recent years. As a result, a wide range of immunomodulatory treatments are offered to women with RPL. Granulocyte colony stimulating factor (G-CSF), either used as an intrauterine infusion or a subcutaneous injection, is thought to have significant benefits in improving reproductive outcomes in women with a previous history of RPL. G-CSF is a cytokine and has important functions in stimulating the proliferation and differentiation of neutrophils and also induces peripheral T regulatory cells. Unlike other immunomodulatory therapy, the use of G-CSF also claims to favor a ‘global immunomodulatory function’ with its effects on endometrial thickness, ovarian follicular function, oocyte quality, and embryo implantation. Furthermore, the reassuring safety data for maternal and neonatal outcomes from the Severe Chronic Neutropenia International Registry makes G-CSF a popular immunomodulatory treatment. In this chapter, the clinical efficacy of G-CSF is evaluated using studies administering G-CSF (either subcutaneously or otherwise as an intrauterine infusion) in women with a previous history of unexplained RPL.

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