Marcello Di Nisio1, Adalisa Ponzano2, Gian Mario Tiboni3, Maria Domenica Guglielmi4, Anne Wilhelmina Saskia Rutjes5, Ettore Porreca6. 1. Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands; Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy. Electronic address: mdinisio@unich.it. 2. Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy; Unit of Assisted Reproductive Technology, Ortona General Hospital, Ortona, Chieti, Italy. 3. Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy; Unit of Assisted Reproductive Technology, Ortona General Hospital, Ortona, Chieti, Italy. Electronic address: tiboni@unich.it. 4. Department of Internal Medicine, Ospedale SS.ma Annunziata, Chieti, Italy. 5. Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland. Electronic address: anne.rutjes@ispm.unibe.ch. 6. Department of Medical, Oral and Biotechnological Sciences, Gabriele D'Annunzio University, Chieti, Italy. Electronic address: eporreca@unich.it.
Abstract
INTRODUCTION: The effects of multiple inherited and acquired thrombophilic defects on the outcome of in-vitro fertilization (IVF) remain unexplored. The aim of this study was to evaluate the association between multiple thrombophilia and clinical outcomes in a large prospective cohort of women undergoing IVF. MATERIALS AND METHODS: Consecutive women scheduled for IVF were eligible. The primary study outcome was live birth. Secondary outcomes included spontaneous abortion, clinical pregnancy, and symptomatic venous thromboembolism. RESULTS: 687 women with a mean age of 34.6 (±3.2) years were included. Overall, 22 women (3.2%) had two or more thrombophilic defects. The probability of live birth was not statistically significantly different between women with ≥2 thrombophilia (odds ratio [OR] 0.62; 95% confidence interval [CI], 0.18 to 2.11) or ≥1 thrombophilia (OR 0.67;95% CI, 0.41 to 1.09) and women without any thrombophilia. None of the individual inherited thrombophilia nor positivity to antiphospholipid antibodies or lupus anticoagulant were associated with live birth. Single positivity for lupus anticoagulant carried a more than threefold higher risk of abortion (OR 3.74; 95% CI, 1.30 to 10.75). There were no statistically significant associations between individual or multiple thrombophilic defects and clinical pregnancy or pregnancy test results. No woman had a history of venous thromboembolism and none developed a thrombotic event during the study. CONCLUSIONS: In women undergoing IVF, the presence of two or more thrombophilic defects was rare and showed no statistically significant associations with IVF outcomes.
INTRODUCTION: The effects of multiple inherited and acquired thrombophilic defects on the outcome of in-vitro fertilization (IVF) remain unexplored. The aim of this study was to evaluate the association between multiple thrombophilia and clinical outcomes in a large prospective cohort of women undergoing IVF. MATERIALS AND METHODS: Consecutive women scheduled for IVF were eligible. The primary study outcome was live birth. Secondary outcomes included spontaneous abortion, clinical pregnancy, and symptomatic venous thromboembolism. RESULTS: 687 women with a mean age of 34.6 (±3.2) years were included. Overall, 22 women (3.2%) had two or more thrombophilic defects. The probability of live birth was not statistically significantly different between women with ≥2 thrombophilia (odds ratio [OR] 0.62; 95% confidence interval [CI], 0.18 to 2.11) or ≥1 thrombophilia (OR 0.67;95% CI, 0.41 to 1.09) and women without any thrombophilia. None of the individual inherited thrombophilia nor positivity to antiphospholipid antibodies or lupus anticoagulant were associated with live birth. Single positivity for lupus anticoagulant carried a more than threefold higher risk of abortion (OR 3.74; 95% CI, 1.30 to 10.75). There were no statistically significant associations between individual or multiple thrombophilic defects and clinical pregnancy or pregnancy test results. No woman had a history of venous thromboembolism and none developed a thrombotic event during the study. CONCLUSIONS: In women undergoing IVF, the presence of two or more thrombophilic defects was rare and showed no statistically significant associations with IVF outcomes.
Authors: Matteo Candeloro; Marcello Di Nisio; Adalisa Ponzano; Gian Mario Tiboni; Nicola Potere; Marco Tana; Anne W S Rutjes; Ettore Porreca Journal: Front Endocrinol (Lausanne) Date: 2020-12-23 Impact factor: 5.555