Di Micco Pierpaolo, Russo Vincenzo, Mastroiacovo Daniela, Bosevski Marijan, Lodigiani Corrado
Department of Internal Medicine, Fatebenefratelli Hospital of Naples, Naples, Italy.
Chair of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" Monaldi Hospital, Naples 80131, Italy.
J Blood Med. 2020 Jun 11;11:185-190. doi: 10.2147/JBM.S248988. eCollection 2020.
In vitro fertilization (IVF) procedures have been frequently associated with antithrombotic treatments, in particular, to aspirin or low-molecular-weight heparin (LMWH). The rationale of this treatment is based on the increase of thrombotic risk occurring in this clinical context. Indeed, both prothrombotic changes of coagulation parameters specifically related to IVF procedures as well as the presence of potential thrombophilic alterations may concur to increase the risk in these women. Furthermore, the presence of thrombophilia has been suggested as a potential cause of recurrent IVF failures. Therefore, antithrombotic treatments have been historically planned to prevent thrombotic disorders during pharmacological ovarian stimulation and/or to increase a successful rate of pregnancy and live births after IVF with embryo transfer. However, up to date, the role of inherited and\or acquired thrombophilia is still debated as well as a univocal therapeutic approach is lacking in women with infertility. The administration of antithrombotic drugs differs in several studies and even the dosages of aspirin and\or low-molecular-weight heparin are different. This review focuses on underlining current evidence on the role of thrombophilia and thromboprophylaxis in women selected for IVF with embryo transfer.
体外受精(IVF)程序经常与抗血栓治疗相关,特别是与阿司匹林或低分子量肝素(LMWH)相关。这种治疗的基本原理是基于在这种临床情况下发生的血栓形成风险增加。事实上,与IVF程序特别相关的凝血参数的促血栓形成变化以及潜在的血栓形成倾向改变的存在可能共同增加这些女性的风险。此外,血栓形成倾向的存在被认为是反复IVF失败的潜在原因。因此,历史上一直计划进行抗血栓治疗,以预防药物性卵巢刺激期间的血栓形成疾病和/或提高IVF胚胎移植后的妊娠成功率和活产率。然而,迄今为止,遗传性和/或获得性血栓形成倾向的作用仍存在争议,而且不育女性缺乏明确的治疗方法。在几项研究中,抗血栓药物的给药方式不同,甚至阿司匹林和/或低分子量肝素的剂量也不同。本综述着重强调目前关于血栓形成倾向和血栓预防在选择进行IVF胚胎移植的女性中的作用的证据。