In vitro Fertilization Procedures with Embryo Transfer and Their Association with Thrombophilia, Thrombosis and Early Antithrombotic Treatments

Abstract

Pierpaolo Di Micco,1 Vincenzo Russo,2 Daniela Mastroiacovo,3 Marijan Bosevski,4 Corrado Lodigiani5 1Department of Internal Medicine, Fatebenefratelli Hospital of Naples, Naples, Italy; 2Chair of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli” Monaldi Hospital, Naples 80131, Italy; 3Angiology Unit, Ospedale SS. Filippo e Nicola, Avezzano, Italy; 4University Cardiology Clinic, Faculty of Medicine, Skopje, N.Macedonia; 5Thrombosis and Hemorrhagic Center, Humanitas Research Hospital and Humanitas University, Rozzano, ItalyCorrespondence: Pierpaolo Di MiccoDepartment of Internal Medicine, Fatebenefratelli Hospital of Naples, Naples, ItalyEmail [email protected]: In vitro fertilization (IVF) procedures have been frequently associated with antithrombotic treatments, in particular, to aspirin or low-molecular-weight heparin (LMWH). The rationale of this treatment is based on the increase of thrombotic risk occurring in this clinical context. Indeed, both prothrombotic changes of coagulation parameters specifically related to IVF procedures as well as the presence of potential thrombophilic alterations may concur to increase the risk in these women. Furthermore, the presence of thrombophilia has been suggested as a potential cause of recurrent IVF failures. Therefore, antithrombotic treatments have been historically planned to prevent thrombotic disorders during pharmacological ovarian stimulation and/or to increase a successful rate of pregnancy and live births after IVF with embryo transfer. However, up to date, the role of inherited and|or acquired thrombophilia is still debated as well as a univocal therapeutic approach is lacking in women with infertility. The administration of antithrombotic drugs differs in several studies and even the dosages of aspirin and|or low-molecular-weight heparin are different. This review focuses on underlining current evidence on the role of thrombophilia and thromboprophylaxis in women selected for IVF with embryo transfer.Keywords: sterility, in vitro fertilization, thrombophilia, low-molecular-weight heparin, aspirin, ovarian hyper-stimulation syndrome

Keywords

• sterility
• in vitro fertilization
• thrombophilia
• low molecular weight heparin
• aspirin
• ovarian hyper-stimulation syndrome