Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands; Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy.
Department of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti-Pescara, Italy; Unit of Assisted Reproductive Technology, Ortona General Hospital, Ortona, Chieti, Italy.
Thromb Res. 2018 Jul;167:26-31. doi: 10.1016/j.thromres.2018.05.006. Epub 2018 May 9.
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.
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.
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.
In women undergoing IVF, the presence of two or more thrombophilic defects was rare and showed no statistically significant associations with IVF outcomes.
多种遗传性和获得性血栓形成倾向缺陷对体外受精（IVF）结局的影响仍不清楚。本研究旨在评估大量接受 IVF 的女性中多种血栓形成倾向与临床结局的相关性。
符合条件的连续进行 IVF 的女性。主要研究结果是活产。次要结果包括自然流产、临床妊娠和症状性静脉血栓栓塞。
687 名平均年龄为 34.6（±3.2）岁的女性被纳入研究。总体而言，22 名女性（3.2%）有两种或两种以上的血栓形成倾向缺陷。有≥2 种血栓形成倾向（优势比 [OR] 0.62；95%置信区间 [CI]，0.18 至 2.11）或≥1 种血栓形成倾向（OR 0.67；95%CI，0.41 至 1.09）的女性与无任何血栓形成倾向的女性相比，活产的可能性无统计学显著差异。个体遗传性血栓形成倾向或抗磷脂抗体或狼疮抗凝剂阳性均与活产无关。狼疮抗凝剂单项阳性与流产风险增加三倍以上相关（OR 3.74；95%CI，1.30 至 10.75）。个体或多种血栓形成倾向缺陷与临床妊娠或妊娠试验结果之间无统计学显著相关性。没有女性有静脉血栓栓塞病史，也没有女性在研究期间发生血栓事件。
在接受 IVF 的女性中，两种或两种以上血栓形成倾向缺陷的存在较为罕见，与 IVF 结局无统计学显著相关性。
