Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Vermont Medical Center, 111 Colchester Ave, Burlington, VT 05401, USA.
Department of Obstetrics, Gynecology, & Reproductive Sciences, University of Vermont Medical Center, 111 Colchester Ave, Burlington, VT 05401, USA.
Thromb Res. 2024 Jun;238:97-102. doi: 10.1016/j.thromres.2024.04.020. Epub 2024 Apr 20.
The association between estrogen and hypercoagulability is well-established but little is known about coagulation dynamics during IVF. Our goal was to measure coagulation potential prior to, during, and following an IVF cycle and to investigate differences by conception outcome.
Patients undergoing IVF with fresh embryo transfer at a single academic center using oral contraceptive pills for cycle batching underwent evaluation of thrombin generation using the calibrated automated thrombogram at multiple points during the IVF cycle. Multiple thrombin generation parameters were compared across timepoints and by IVF cycle outcome using ANOVA repeated measures analysis.
Of the 17 patients included, 11 conceived. There was a significant increase in peak and total thrombin generation in the entire cohort between the pre-treatment natural follicular phase and following a short course of oral contraceptive pills used for cycle batching. Further increase in these parameters was seen at the time of oocyte retrieval. In the pre-treatment natural follicular phase, patients who conceived had lower peak thrombin generation. There were changes throughout the cycle for factors II, V, VIII, X, XI, XII, antithrombin, and tissue factor pathway inhibitor. Only Factor XI was distinguishable by conception status; values were lower at all visits in patients who conceived.
Increases in coagulation potential are seen in patients undergoing IVF following a short course of oral contraceptive pills for cycle batching and continue during controlled ovarian hyperstimulation. Those who conceived were seen to have lower peak thrombin generation in the pre-treatment natural follicular phase.
雌激素与高凝状态之间的关联已得到充分证实，但人们对体外受精（IVF）期间的凝血动力学知之甚少。我们的目标是在 IVF 周期之前、期间和之后测量凝血潜力，并调查受孕结果的差异。
在一家学术中心进行新鲜胚胎移植的 IVF 患者，使用口服避孕药进行周期批量处理，在 IVF 周期的多个时间点使用校准自动血栓图评估血栓生成。使用方差重复测量分析比较了多个血栓生成参数在时间点和 IVF 周期结果之间的差异。
在 17 名纳入的患者中，有 11 名受孕。整个队列中，在预处理自然卵泡期和用于周期批量处理的短期口服避孕药之后，峰值和总血栓生成明显增加。在取卵时，这些参数进一步增加。在预处理自然卵泡期，受孕的患者的峰值血栓生成较低。整个周期中，因子 II、V、VIII、X、XI、XII、抗凝血酶和组织因子途径抑制剂都发生了变化。只有因子 XI 可以通过受孕状态来区分；在受孕的患者中，所有就诊时的数值均较低。
在接受短期口服避孕药周期批量处理的 IVF 患者中，凝血潜力增加，并且在控制性卵巢过度刺激期间持续增加。在预处理自然卵泡期，受孕的患者的峰值血栓生成较低。
