Significance of detecting antiphospholipid antibodies and genetic mutations of hemostasis for in vitro fertilization

Abstract

A case of pregravid preparation is described for an in vitro fertilization (IVF) attempt in a woman after four previous IVF failures. Considering her personal and family aggravated medical history, including the family anamnesis, the patient underwent a hemostasis examination including a test for genetic mutations. A high titer of antiphospholipid antibodies of various types and multigene mutations associated with thrombophilia were found. For the treatment of acquired and inherited thrombophilia, vitamin-antioxidant and intravenous immunoglobulin therapy was initiated as well as a course of hirudotherapy. After starting of pregnancy throughout the gestation period, anticoagulant therapy by low molecular weight heparins, antiplatelet, and antioxidant therapy was carried out; in parallel, D-dimer, thrombin-antithrombin and platelet aggregation markers of thrombophilia were monitored. Pregnancy successfully ended by childbirth at 39 weeks.

Keywords

• antiphospholipid antibodies
• acquired and genetic thrombophilia
• in vitro fertilization failure
• immune therapy
• hirudotherapy