OBJECTIVE: To determine the incidence and the increase in risk of venous thromboembolism (VTE) in relation to IVF and ovarian hyperstimulation syndrome (OHSS) in successful cycles. DESIGN: Cohort study. SETTING: Population based. PATIENT(S): All deliveries (n = 964,532) in Sweden during a 10-year period (1999-2008). INTERVENTION(S): Comparison of VTEs among those with and without IVF. The National Birth Registry was cross-matched with both the National Discharge Registry and the National IVF Registry. Logistic regression analysis was used to determine odds ratios and 95% confidence intervals. MAIN OUTCOME MEASURE(S): Risk of first trimester VTE. RESULT(S): The incidence of first-trimester VTE in relation to IVF was 0.2%, representing a 10-fold increase as compared with the background population. The 6% to 7% of IVF pregnancies that were complicated by OHSS showed a 100-fold increased risk of VTE, as opposed to the fivefold increased risk seen in the absence of OHSS. The VTEs in conjunction with IVF were diagnosed at a mean gestational age of 62 days; there was no increased risk of VTE related to frozen embryo replacement cycles or IVF after the first trimester. CONCLUSION(S): Treating women with OHSS with low-molecular-weight heparin thromboprophylaxis during the first trimester and treating cases at high-risk for OHSS with frozen embryo replacement is likely to lower the risk of VTE.
OBJECTIVE: To determine the incidence and the increase in risk of venous thromboembolism (VTE) in relation to IVF and ovarian hyperstimulation syndrome (OHSS) in successful cycles. DESIGN: Cohort study. SETTING: Population based. PATIENT(S): All deliveries (n = 964,532) in Sweden during a 10-year period (1999-2008). INTERVENTION(S): Comparison of VTEs among those with and without IVF. The National Birth Registry was cross-matched with both the National Discharge Registry and the National IVF Registry. Logistic regression analysis was used to determine odds ratios and 95% confidence intervals. MAIN OUTCOME MEASURE(S): Risk of first trimester VTE. RESULT(S): The incidence of first-trimester VTE in relation to IVF was 0.2%, representing a 10-fold increase as compared with the background population. The 6% to 7% of IVF pregnancies that were complicated by OHSS showed a 100-fold increased risk of VTE, as opposed to the fivefold increased risk seen in the absence of OHSS. The VTEs in conjunction with IVF were diagnosed at a mean gestational age of 62 days; there was no increased risk of VTE related to frozen embryo replacement cycles or IVF after the first trimester. CONCLUSION(S): Treating women with OHSS with low-molecular-weight heparin thromboprophylaxis during the first trimester and treating cases at high-risk for OHSS with frozen embryo replacement is likely to lower the risk of VTE.
Authors: Shannon M Bates; Anita Rajasekhar; Saskia Middeldorp; Claire McLintock; Marc A Rodger; Andra H James; Sara R Vazquez; Ian A Greer; John J Riva; Meha Bhatt; Nicole Schwab; Danielle Barrett; Andrea LaHaye; Bram Rochwerg Journal: Blood Adv Date: 2018-11-27
Authors: Kelly Comerford Wormer; Ayesha A Jangda; Farah A El Sayed; Katherine I Stewart; Sunni L Mumford; James H Segars Journal: Eur J Obstet Gynecol Reprod Biol Date: 2018-03-19 Impact factor: 2.435