Thrombophilia refers to a coagulation disorder that predisposes to thrombosis and thus increases the risk of thrombotic events. Both inherited and acquired thrombophilia are associated with vascular thrombosis and pregnancy-related complications, including infertility, recurrent miscarriage, and premature birth.
Recently, thrombophilia has been increasingly encountered as an infertility factor, which gives the clinical relevance of the disease.
The aim of the study was to investigate the prognostic role of thrombophilia in the treatment of infertility and the pregnancy of thrombophilic women during assisted reproduction procedures.
Frequency of abortions increases and effectiveness of in vitro fertilization (IVF) decreases with age. Normal weight has a positive effect on assisted reproduction techniques (ART’s) outcome. Repeat IVF failure is more common in thrombophilia than in healthy women, and the “take home baby” ratio for IVF is 24%. Spontaneous abortion was most commonly observed in the PAI homozygous group followed by MTHFR homozygous mutation, MTHFR heterozygous mutation, and Factor V (Leiden) mutation. The most effective treatment was concomitant therapy with low molecular weight heparin and aspirin.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. de Jong P. G. Kaandorp S. di Nisio M. Aspirin and/or heparin for women with unexplained recurrent miscarriage with or without inherited thrombophilia Cochrane Pregnancy and Childbirth Group 2014 10.1002/14651858.CD004734.pub4
2. La Farina F. Raparelli V. Napoleone L. Guadagni F. Basili S. Ferroni P. Inflammation and Thrombophilia in Pregnancy Complications: Implications for Risk Assessment and Clinical Management Cardiovascular and hematological disorders drug targets 2016;15(3):187-203
3. Squizzato A. Romualdi E. Büller H.R. Gerdes V. E. A. Thyroid Dysfunction and Effects on Coagulation and Fibrinolysis: A Systematic Review. J Clin Endocrinol Metab 2007; 92 (7): 2415-2420. doi: 10.1210/jc.2007-0199
4. Bellver J. Soares S. Álvarez C. Muñoz E. Ramírez A. et al. The role of thrombophilia and thyroid autoimmunity in unexplained infertility implantation failure and recurrent spontaneous abortion. Hum Reprod 2008; 23 (2): 278-284.
5. Verma I. Sood R. Juneja S. Kaur S. Prevalence of hypothyroidism in infertile women and evaluation of response of treatment for hypothyroidism on infertility. International Journal of Applied and Basic Medical Research. 2012;2(1):17-19.
6. Pagliardini L Vigano’ P. Molgora M. et al. High Prevalence of Vitamin D Deficiency in Infertile Women Referring for Assisted Reproduction. Nutrients. 2015;7(12):9972-9984.
7. Bulletti C. et al. “Endometriosis and Infertility.” Journal of Assisted Reproduction and Genetics 27.8 (2010): 441–447. PMC. Web. 27 June 2017.
8. Brown J. Farquhar C.- Endometriosis: an overview of Cochrane Reviews Cochrane Database of Systematic Reviews 2014 10.1002/14651858.CD009590.pub2
9. Tsanadis G. Vartholomatos G. Korkontzelos I. Avgoustatos F. Kakosimos G. Sotiriadis A. Tatsioni A. Eleftheriou A. Lolis D. Polycystic ovarian syndrome and thrombophilia. Hum Reprod 2002; 17 (2): 314-319.
10. Strandell A. Lindhard A.; Why does hydrosalpinx reduce fertility?: The importance of hydrosalpinx fluid. Hum Reprod 2002; 17 (5): 1141-1145.
11. Parihar M. Mirge A. Hasabe R. Hydrosalpinx Functional Surgery or Salpingectomy? The Importance of Hydrosalpinx Fluid in Assisted Reproductive Technologies. Journal of Gynecological Endoscopy and Surgery. 2009;1(1):12-16.
12. Bozic-Mijovski M. Hyperhomocysteinemia and thrombophilia Clin Chem Lab Med. 2010 Dec;48 Suppl 1:S89-95.
13. Jones E.E.- Hyperprolactinemia and female infertility 1989 Feb;34(2):117-26
14. The Long-Term Impact of Medical Complications in Pregnancy- A Window into Maternal and Fetal Future Health Eyal Sheiner Ed. 2016 chapter 5. Recurrent Pregnancy Loss
15. Sauer M.V. Reproduction at an advanced maternal age and maternal health Fertil Steril 2015 103(5): 1136-43
16. Simcox L.E. Ormesher L. Tower C. et al. Thrombophilia and Pregnancy complications International Journal of Molecular Sciences 2015 16(12): 28418–28428
17. Kovacheva K. Ivanov P. Konova E. Simeonova M. Komsa-Penkova R. Genetic thrombophilic defects (Factor V Leiden prothrombin G20210A MTHFR C677T) in women with recurrent fetal loss Akush Ginekol (Sofiia) 2007;46(7):10-6.
18. Tan J.Y. Thrombophilia in pregnancy. Ann Acad Med Singapore. 2002 May;31(3):328-34.
19. Cardona H.1. Castañeda S.A. Cardona Maya W. Alvarez L. Gómez J. Gómez J. Torres J. Tobón L. Bedoya G. Cadavid A.P. Lack of Association between Recurrent Pregnancy Loss and Inherited Thrombophilia in a Group of Colombian Patients. Thrombosis. 2012;2012:367823. doi: 10.1155/2012/367823. Epub 2012 Apr 11.
20. Nybo Andersen A-M et al. “Is Maternal Age an Independent Risk Factor for Fetal Loss?” Western Journal of Medicine 173.5 (2000): 331.
21. Qublan H.S.1. Eid S.S. Ababneh H.A. Amarin Z.O. Smadi A.Z. Al-Khafaji F.F. Khader Y.S.. Acquired and inherited thrombophilia: implication in recurrent IVF and embryo transfer failure. Hum Reprod. 2006 Oct;21(10):2694-8. Epub 2006 Jul 11.
22. Puscheck E.E. Woodard T.L.- Infertility American Society for Reproductive Medicine 2016
23. Doszpod J. Az intrauterin magzat Medicina könyvkiadó Budapest 2000 313-322
24. Dag Z. Ö. Dilbaz B. Impact of obesity on infertility in women Journal of Turkish-German Gynecological Association 2015 16(2): 111-117
25. Areia A.L. Fonseca E. Areia M. et al. Low molecular weight heparin plus aspirin versus aspirin alone in pregnant women with hereditary thrombophilia to improve live birth rate Arch Gynecol Obstet 2016 293:81
26. Sokol V. Ivanisevik M. Herman M. Delmis J. The role of low molecular weight heparin in women with hereditary thrombophilia for a good perinatal outcome Acta clinica Croatica 2016 55(2):309-15
27. De Carolis S. Ferrazzani S. De Stefano V. Garofalo S. Fatigante G. Rossi E. Leone G. Caruso A. Inherited thrombophilia: treatment during pregnancy. Fetal Diagn Ther 2006; 21:281-286
28. Goldstajn M.S. Kovacevik D. The effect of thrombophilia on pregnancy outcome and IVF success Collegium Antropolegicum 2014 38(4):1153-61