Departments of Internal Medicine D and E, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Thromb Haemost. 2012 Dec;108(6):1192-7. doi: 10.1160/TH12-06-0381. Epub 2012 Oct 10.
Assisted reproductive technology (ART) is extensively used as a tool for pregnancy achievement in subfertile couples. Congenital and acquired thrombophilias have been suggested by some investigators to play a role in abnormal embryo implantation and placentation. The objective of this study was to assess the role of common thrombophilias in women with unexplained infertility undergoing in vitro fertilisation (IVF). We retrospectively analysed 594 women from a large healthcare maintenance organisation going through IVF and who had a thrombophilia workup, and compared them for prevalence of thrombophilia to two reference groups consisting of 637 fertile women from previous work and 17,337 women members of the same healthcare organisation with no history of venous thromboembolism. The mean age of the women at the first cycle of IVF was 30.9 years (SD: 4.1).The mean number of IVF cycles was 7.3 (SD: 5.0), and the mean fertility success rate per woman was 14.6% (SD: 19.0%). None of the common thrombophilias tested was found to be significantly associated with the number of IVF cycles or with lower fertility success rate. Rather, women who had APCR and /or factor V Leiden and lupus anticoagulant had significantly higher live birth rates (12.3% and 12.6%, respectively) in comparison to women who were tested negative (9.0% and 9.7%, respectively). Thus, hypercoagulability is not associated with failure to achieve pregnancy. These data suggest that neither screening for thrombophilia nor anticoagulant treatment is indicated in cases with unexplained reproductive failure.
辅助生殖技术（ART）被广泛用作不孕夫妇怀孕的工具。一些研究人员认为先天性和获得性血栓形成倾向在胚胎着床和胎盘形成异常中起作用。本研究旨在评估常见血栓形成倾向在接受体外受精（IVF）的不明原因不孕妇女中的作用。我们回顾性分析了来自一个大型医疗保健机构的 594 名接受 IVF 且进行血栓形成倾向检查的妇女，并将其与以前工作中的 637 名生育能力妇女和同一医疗保健机构中无静脉血栓栓塞史的 17,337 名妇女的参考组进行比较。妇女在首次 IVF 周期的平均年龄为 30.9 岁（标准差：4.1）。平均 IVF 周期数为 7.3（标准差：5.0），平均每位妇女的生育成功率为 14.6%（标准差：19.0%）。未发现任何常见的血栓形成倾向与 IVF 周期数或较低的生育成功率显著相关。相反，与检测结果为阴性的妇女（分别为 9.0%和 9.7%）相比，具有 APCR 和/或因子 V Leiden 和狼疮抗凝剂的妇女的活产率显著更高（分别为 12.3%和 12.6%）。因此，血液高凝状态与妊娠失败无关。这些数据表明，在不明原因生殖失败的情况下，既不需要筛查血栓形成倾向，也不需要抗凝治疗。
