Azem Foad, Many Ariel, Ben Ami Ido, Yovel Israel, Amit Ami, Lessing Joseph B, Kupferminc Michael J
Department of Obstetrics and Gynecology, Lis Maternity Hospital and Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Hum Reprod. 2004 Feb;19(2):368-70. doi: 10.1093/humrep/deh069.
We investigated whether hereditary thrombophilia is more prevalent in women with recurrent IVF-embryo transfer failures.
This case-control study was conducted in an academic tertiary care hospital and compared 45 women with a history of four or more failed IVF cycles (group A) with 44 apparently healthy women matched for age and ethnic origin (group B). All participants were tested for inherited thrombophilias: mutations of prothrombin, factor V Leiden and methylene tetrahydrofolate reductase (MTHFR), and protein C, protein S and antithrombin III deficiencies.
Excluding homozygotic MTHFR, the incidence of thrombophilia in group A, was 26.7% compared with 9.1% in group B (P = 0.003; odds ratio 2.9; 95% confidence interval 1.02-8.4). The incidence of thrombophilia in women with unexplained infertility in group A was 42.9% (9/21), compared with 18.2% in group B (P < 0.002).
These data suggest that inherited thrombophilia may play a role in the aetiology of repeated IVF failures, particularly in the subgroup with unexplained fertility.
我们研究了遗传性易栓症在反复体外受精-胚胎移植失败的女性中是否更普遍。
本病例对照研究在一家学术性三级医疗机构进行，将45名有四次或更多次体外受精周期失败史的女性（A组）与44名年龄和种族匹配的明显健康女性（B组）进行比较。所有参与者都接受了遗传性易栓症检测：凝血酶原、因子V莱顿和亚甲基四氢叶酸还原酶（MTHFR）的突变，以及蛋白C、蛋白S和抗凝血酶III缺乏症。
排除纯合子MTHFR后，A组易栓症的发生率为26.7%，而B组为9.1%（P = 0.003；比值比2.9；95%置信区间1.02 - 8.4）。A组不明原因不孕女性中易栓症的发生率为(42.9%)（9/21），而B组为(18.2%)（P < 0.002）。
这些数据表明，遗传性易栓症可能在反复体外受精失败的病因中起作用，特别是在不明原因不孕的亚组中。
