Debate: Should Filgrastim Be Used for Recurrent Pregnancy Loss? Yes

Le résumé fourni par la source

In this chapter the role of G-CSF or filgrastim in the treatment of unexplained recurrent pregnancy loss (RPL) is reviewed. The clinical use of filgrastim, in the treatment of neutropenia, such as chronic idiopathic neutropenia or post-chemotherapy neutropenia, is discussed, as well as its use in case of hematopoietic stem cell donation or transplantation. The definition of RPL is discussed considering the differences in the terms used by scientific Society papers on this issue, to clarify which group of patients may be treated with G-CSF. The effectiveness of filgrastim in the treatment of unexplained RPL is presented and discussed according to the literature data. The aneuploidy role in miscarriage is discussed, tested by cell-free DNA analysis of maternal blood or embryonic tissue in a previous miscarriage; this is mandatory to rule out embryo aneuploidy as a cause of pregnancy loss before suggesting G-CSF treatment. In the same way as for women with recurrent implantation failure, G-CSF treatment should be reserved for patients who have undergone PGT-A in which a healthy blastocyst is transferred. The possible mechanisms of action of this treatment is discussed as well as its safety according to literature data.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.