Clinical Pregnancies and Live Births in women approaching ART: A follow-up analysis of 157 women after thrombophilia screening

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• 作者：E. Gr ; one ; M. Villani ; G.L. Tiscia ; F. Dentali ; D. Colaizzo ; F. Cappucci ; E. Chinni ; W. Ageno ; M. Margaglione
• 刊名：Thrombosis Research
• 出版年：February, 2014
• 年：2014
• 卷：133
• 期：2
• 页码：168-172
• 全文大小：250 K

文摘

Introduction

The role of thrombophilia screening and antithrombotic therapy in unselected women undergone Assisted Reproductive Technologies (ART) is largely unknown. Nonetheless, in many Countries infertile women undergo thrombophilia screening and/or antithrombotic therapy.

Materials and Methods

We carried out a follow-up study. The original sample (n = 1107) consisted of infertile women observed in 13 years. A cohort of 157 women with at least 1 cycle before thrombophilia test and 1 after test was investigated. All underwent thrombophilia screening; an antithrombotic treatment was prescribed in 216 out of 801 cycles. Clinical pregnancy and live birth rates were the main clinical objectives.

Results

Overall, 15 (9.6%) women carried thrombophilia. The Cox regression showed that LMWH alone or combined with ASA was significantly associated with the outcome "live birth" 鈥渓ive births鈥?(p: 0.015, HR: 2.8, 95%CI: 1.2-6.6 for combined therapy), independently of the carriership of thrombophilia. Women with a lower number of attempts had a higher likelihood of delivering a live-born child using the combined therapy (p < 0.001, HR: 0.7, 95%CI: 0.7-0.8), independently of the presence of thrombophilia.

Conclusions

A potential benefit of LMWH in improving number of live births, independently of the presence of thrombophilia, is suggested. Universal thrombophilia screening before ART is not useful to discriminate women with a worse pregnancy prognosis.