Institut Clinic Gynecology, Obstetrics and Neonatology (ICGON), Hospital Clinic, C/Villarroel 160, Barcelona 08036, Spain.
IVI RMA Madrid, Avda. del Talgo 68, Madrid 28023, Spain.
Eur J Obstet Gynecol Reprod Biol. 2023 Jan;280:12-21. doi: 10.1016/j.ejogrb.2022.10.024. Epub 2022 Oct 31.
Thrombophilia is a group of inherited or acquired coagulation disorders that have been associated with reproductive failure. However, there are still no clear recommendations on whether its inclusion in the initial study of the infertile couple or patients with recurrent implantation failure is necessary. In this discussion paper, based on a SWOT (strengths, weaknesses, opportunities, threats) analysis, the different aspects of the repercussions of thrombophilia screening and treatment in reproduction are evaluated. To avoid possible subjectivity in the analysis and results of this study, researchers followed Oxford criteria for the evaluation of evidence. The results from the evaluation of the reviewed bibliography seem to indicate that, pending new evidence, it would be advisable not to include thrombophilia screening in the initial baseline study of the infertile couple. There is no evidence to support a clear association between thrombophilia and implantation failure or infertility. Thrombophilia testing in this setting may increase cost, with minimal potential benefit and lead to inappropriate use of anticoagulants with possible deleterious adverse effects. Future well-designed studies are needed to assess the possible benefit of anticoagulant therapy in infertile thrombophilic patients with implantation failure.
血栓形成倾向是一组与生殖失败相关的遗传性或获得性凝血障碍。然而，对于在不孕夫妇或反复着床失败患者的初始研究中是否需要纳入血栓形成倾向的检查，目前仍没有明确的建议。在这份讨论文件中，我们基于 SWOT（优势、劣势、机会、威胁）分析，评估了血栓形成倾向检查和治疗在生殖领域中的不同影响。为了避免本研究分析和结果的可能主观性，研究人员遵循了牛津证据评估标准。对文献综述的评估结果似乎表明，在新证据出现之前，不建议将血栓形成倾向检查纳入不孕夫妇的初始基础研究中。目前尚无证据表明血栓形成倾向与着床失败或不孕之间存在明确关联。在这种情况下进行血栓形成倾向检查可能会增加成本，潜在获益极小，并导致可能产生不良影响的抗凝剂的不适当使用。未来需要进行精心设计的研究，以评估在着床失败的血栓形成倾向不孕患者中抗凝治疗的可能获益。
