Matteo Candeloro1, Marcello Di Nisio2,3, Adalisa Ponzano4, Gian Mario Tiboni1, Nicola Potere5, Marco Tana5, Anne W S Rutjes6, Ettore Porreca1. 1. Department of Medical, Oral and Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy. 2. Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy. 3. Department of Vascular Medicine, Academic Medical Center, Amsterdam, Netherlands. 4. Unit of Gynecology and Obstetrics, "Floraspe Renzetti" Hospital, Lanciano, Italy. 5. Unit of Internal Medicine, "SS Annunziata" Hospital, Chieti, Italy. 6. Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
Abstract
Introduction: Obesity is associated with a higher risk of abortion in women undergoing in vitro fertilization (IVF). Whether thrombophilia amplifies this risk is currently unclear. The aim of this study was to evaluate the effects of thrombophilia on the risk of abortion in obese women treated with IVF. Methods: Patient characteristics, presence of inherited or acquired thrombophilia, and comorbidities were prospectively collected before the procedure in consecutive women undergoing IVF. The primary outcome was the incidence of abortion among women who achieved a clinical pregnancy. Results: A total of 633 non-obese and 49 obese Caucasian women undergoing IVF were included. 204 (32%) women achieved clinical pregnancy, of whom six had an ectopic pregnancy and 63 experienced an abortion. The incidence of abortion was higher in obese women compared to non-obese women after adjusting for age (64.3% vs. 29.3%, odds ratio [OR] 4.41; 95% CI 1.41 to 13.81). Women with one or more thrombophilia were at increased risk of abortion relative to those without thrombophilia (OR 2.70; 95% CI 1.34 to 5.45), and the risk seemed to be higher with hereditary (OR 5.12; 95% CI 1.77 to 14.8) than acquired thrombophilia (OR 1.92; 95% CI 0.52 to 5.12; p for interaction 0.194). Among obese women, the presence of one or more thrombophilia seemed associated with a substantially increased risk of abortion (unadjusted OR 14.00; 95% CI 0.94 to 207.6). Conclusions: Obese women undergoing IVF have a high risk of abortion which seems further amplified by the concomitant presence of thrombophilia.
Introduction: Obesity is associated with a higher risk of abortion in women undergoing in vitro fertilization (IVF). Whether thrombophilia amplifies this risk is currently unclear. The aim of this study was to evaluate the effects of thrombophilia on the risk of abortion in obesewomen treated with IVF. Methods:Patient characteristics, presence of inherited or acquired thrombophilia, and comorbidities were prospectively collected before the procedure in consecutive women undergoing IVF. The primary outcome was the incidence of abortion among women who achieved a clinical pregnancy. Results: A total of 633 non-obese and 49 obese Caucasian women undergoing IVF were included. 204 (32%) women achieved clinical pregnancy, of whom six had an ectopic pregnancy and 63 experienced an abortion. The incidence of abortion was higher in obesewomen compared to non-obesewomen after adjusting for age (64.3% vs. 29.3%, odds ratio [OR] 4.41; 95% CI 1.41 to 13.81). Women with one or more thrombophilia were at increased risk of abortion relative to those without thrombophilia (OR 2.70; 95% CI 1.34 to 5.45), and the risk seemed to be higher with hereditary (OR 5.12; 95% CI 1.77 to 14.8) than acquired thrombophilia (OR 1.92; 95% CI 0.52 to 5.12; p for interaction 0.194). Among obesewomen, the presence of one or more thrombophilia seemed associated with a substantially increased risk of abortion (unadjusted OR 14.00; 95% CI 0.94 to 207.6). Conclusions: Obesewomen undergoing IVF have a high risk of abortion which seems further amplified by the concomitant presence of thrombophilia.
Authors: A M Kolte; L A Bernardi; O B Christiansen; S Quenby; R G Farquharson; M Goddijn; M D Stephenson Journal: Hum Reprod Date: 2014-11-05 Impact factor: 6.918
Authors: C Calhaz-Jorge; C De Geyter; M S Kupka; J de Mouzon; K Erb; E Mocanu; T Motrenko; G Scaravelli; C Wyns; V Goossens Journal: Hum Reprod Date: 2017-10-01 Impact factor: 6.918
Authors: Ashkan Afshin; Mohammad H Forouzanfar; Marissa B Reitsma; Patrick Sur; Kara Estep; Alex Lee; Laurie Marczak; Ali H Mokdad; Maziar Moradi-Lakeh; Mohsen Naghavi; Joseph S Salama; Theo Vos; Kalkidan H Abate; Cristiana Abbafati; Muktar B Ahmed; Ziyad Al-Aly; Ala’a Alkerwi; Rajaa Al-Raddadi; Azmeraw T Amare; Alemayehu Amberbir; Adeladza K Amegah; Erfan Amini; Stephen M Amrock; Ranjit M Anjana; Johan Ärnlöv; Hamid Asayesh; Amitava Banerjee; Aleksandra Barac; Estifanos Baye; Derrick A Bennett; Addisu S Beyene; Sibhatu Biadgilign; Stan Biryukov; Espen Bjertness; Dube J Boneya; Ismael Campos-Nonato; Juan J Carrero; Pedro Cecilio; Kelly Cercy; Liliana G Ciobanu; Leslie Cornaby; Solomon A Damtew; Lalit Dandona; Rakhi Dandona; Samath D Dharmaratne; Bruce B Duncan; Babak Eshrati; Alireza Esteghamati; Valery L Feigin; João C Fernandes; Thomas Fürst; Tsegaye T Gebrehiwot; Audra Gold; Philimon N Gona; Atsushi Goto; Tesfa D Habtewold; Kokeb T Hadush; Nima Hafezi-Nejad; Simon I Hay; Masako Horino; Farhad Islami; Ritul Kamal; Amir Kasaeian; Srinivasa V Katikireddi; Andre P Kengne; Chandrasekharan N Kesavachandran; Yousef S Khader; Young-Ho Khang; Jagdish Khubchandani; Daniel Kim; Yun J Kim; Yohannes Kinfu; Soewarta Kosen; Tiffany Ku; Barthelemy Kuate Defo; G Anil Kumar; Heidi J Larson; Mall Leinsalu; Xiaofeng Liang; Stephen S Lim; Patrick Liu; Alan D Lopez; Rafael Lozano; Azeem Majeed; Reza Malekzadeh; Deborah C Malta; Mohsen Mazidi; Colm McAlinden; Stephen T McGarvey; Desalegn T Mengistu; George A Mensah; Gert B M Mensink; Haftay B Mezgebe; Erkin M Mirrakhimov; Ulrich O Mueller; Jean J Noubiap; Carla M Obermeyer; Felix A Ogbo; Mayowa O Owolabi; George C Patton; Farshad Pourmalek; Mostafa Qorbani; Anwar Rafay; Rajesh K Rai; Chhabi L Ranabhat; Nikolas Reinig; Saeid Safiri; Joshua A Salomon; Juan R Sanabria; Itamar S Santos; Benn Sartorius; Monika Sawhney; Josef Schmidhuber; Aletta E Schutte; Maria I Schmidt; Sadaf G Sepanlou; Moretza Shamsizadeh; Sara Sheikhbahaei; Min-Jeong Shin; Rahman Shiri; Ivy Shiue; Hirbo S Roba; Diego A S Silva; Jonathan I Silverberg; Jasvinder A Singh; Saverio Stranges; Soumya Swaminathan; Rafael Tabarés-Seisdedos; Fentaw Tadese; Bemnet A Tedla; Balewgizie S Tegegne; Abdullah S Terkawi; J S Thakur; Marcello Tonelli; Roman Topor-Madry; Stefanos Tyrovolas; Kingsley N Ukwaja; Olalekan A Uthman; Masoud Vaezghasemi; Tommi Vasankari; Vasiliy V Vlassov; Stein E Vollset; Elisabete Weiderpass; Andrea Werdecker; Joshua Wesana; Ronny Westerman; Yuichiro Yano; Naohiro Yonemoto; Gerald Yonga; Zoubida Zaidi; Zerihun M Zenebe; Ben Zipkin; Christopher J L Murray Journal: N Engl J Med Date: 2017-06-12 Impact factor: 91.245