Diaz-Nuñez Maria, Rabanal Aintzane, Expósito Antonia, Ferrando Marcos, Quintana Fernando, Soria Jose Manuel, Matorras Roberto
Human Reproduction Unit, Cruces University Hospital, Biocruces, Barakaldo, Spain.
IVI Bilbao, Bizkaia, Spain.
J Reprod Infertil. 2019 Apr-Jun;20(2):76-82.
The role of acquired thrombophilia has been accepted as an etiology of recurrent miscarriage (RM); however, the contribution of specific inherited thrombophilic genes to this disorder has remained controversial. An increased incidence of RM has been suggested in women with inherited thrombophilia.
In this prospective study, assisted women with RM or repeated implant failure (RIF) were subjected to Thromboincode analysis, in order to identify 12 genetic variants for Factor V Leiden, Factor V Hong Kong, Factor V Cambridge, FII, FXIII, FXII, and A1 carriers. Patients included in this study were separated in RM cases (n=43), RIF cases (n=36) and RIF+RM (n=76). As a control group, patients undergoing IVF treatment (n=34) were used and a previously described 249 cases population as a representative sample of Spanish population were selected. Level of statistical significance was p<0.05 and groups were compared by Fisher test, except for age that was compared by t-test.
Regarding FXIII, higher values were observed in RM (69.76%), RIF (70%) and in RM+RIF (68.42%) group when compared with our control group (52.94%) and general Spanish population (56.5%), but these differences were statistically significant only in RIF group (p=0.043, p=0.01).
Concerning our findings, both RM and RIF patients had a very similar panel of thrombophilia polymorphisms, suggesting that, in both, thrombophilia might have an important contribution. High frequency of Val34Leu polymorphism in RM/ RIF presumably speaks in favor of a multifactorial RM genesis, wherean altered thrombophilia status plays a role.
获得性血栓形成倾向作为复发性流产(RM)的病因已被认可;然而,特定遗传性血栓形成倾向基因对该疾病的影响仍存在争议。有研究表明,遗传性血栓形成倾向的女性复发性流产的发生率增加。
在这项前瞻性研究中,对患有复发性流产或反复植入失败(RIF)的辅助生殖女性进行血栓编码分析,以确定凝血因子V莱顿、凝血因子V香港、凝血因子V剑桥、凝血因子II、凝血因子XIII、凝血因子XII和A1携带者的12种基因变异。本研究纳入的患者分为复发性流产组(n = 43)、反复植入失败组(n = 36)和反复植入失败合并复发性流产组(n = 76)。作为对照组,使用接受体外受精治疗的患者(n = 34),并选择先前描述的249例人群作为西班牙人群的代表性样本。统计学显著性水平为p<0.05,除年龄采用t检验比较外,各组间采用Fisher检验进行比较。
关于凝血因子XIII,与我们的对照组(52.94%)和西班牙普通人群(56.5%)相比,在复发性流产组(69.76%)、反复植入失败组(70%)和反复植入失败合并复发性流产组(68.42%)中观察到更高的值,但这些差异仅在反复植入失败组中具有统计学显著性(p = 0.043,p = 0.01)。
根据我们的研究结果,复发性流产患者和反复植入失败患者具有非常相似的血栓形成倾向多态性谱,这表明在这两种情况下,血栓形成倾向可能都有重要影响。复发性流产/反复植入失败中Val34Leu多态性的高频率可能支持多因素复发性流产的发生机制,其中改变的血栓形成倾向状态起作用。