Izvorni znanstveni članak
The Effect of Trombophilia on Pregnancy Outcome and IVF Success
Marina Šprem Goldštajn
; Department for Gynecology and Obstetrics, Medical School University of Zagreb, Zagreb, Croatia
Daria Kovačević
; Medical School, University of Zagreb, Zagreb
Sažetak
Thrombophilia is a group of inherited and acquired coagulation disorders often associated with an increased risk of
thrombosis. Over the last decade, inherited thrombophilia is often referred as a possible cause of recurrent miscarriages
and in vitro fertilisation (IVF) failure. However, many studies in this area still give confl icting results, so the goal of our
study was to determine the effect of thrombophilia on pregnancy outcome and success of IVF. The study included 38 patients
with proven gene mutation for thrombophilia and 53 patients without mutations. The studied parameters were age,
duration of infertility, dose of gonadotropins, duration of stimulation, number of embryo transfer (ET), number of oocytes
retrieved, the number of days to ET and the outcome in terms of delivery (full term or premature), ectopic pregnancy or
abortion. There was no signifi cant difference between two groups in the number of procedures performed, the number of
twin pregnancies, abortions, twin miscarriages, ectopic pregnancies, births and the etiology of infertility. A statistically
signifi cant difference was found in the number of pregnancies (p=0.018) and in duration of infertility which was signifi -
cantly longer in the group with thrombophilia (p<0.001). The number of abortions in homozygous PAI-1 was signifi -
cantly more common (p=0.012). Procedures in natural cycle were signifi cantly more frequent in group with thrombophila
(p=0.011), so we recommend in patients with proven mutation fi rst to start with procedures in the natural cycle, and only
in case of failure to use the possibility of stimulating cycles. In conclusion, in patients on anticoagulant therapy a higher
percentage of IVF failure has not been proven. Therefore, we strongly recommend the prophylactic use of low molecular
weight heparin during pregnancy and screening for the most common mutations in our population, particularly in patients
with a history of IVF failure and those with a long duration of infertility.
Ključne riječi
inherited thrombophilia; IVF; low molecular weight heparin
Hrčak ID:
147408
URI
Datum izdavanja:
26.12.2014.
Posjeta: 865 *