Clinical Pregnancies and Live Births in women approaching ART: a follow-up analysis of 157 women after thrombophilia screening.
Thromb Res
; 133(2): 168-72, 2014 Feb.
Article
in En
| MEDLINE
| ID: mdl-24321417
ABSTRACT
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 ANDMETHODS:
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" "live births" (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.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Heparin, Low-Molecular-Weight
/
Thrombophilia
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Reproductive Techniques, Assisted
/
Anticoagulants
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adult
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Female
/
Humans
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Middle aged
/
Pregnancy
Language:
En
Journal:
Thromb Res
Year:
2014
Document type:
Article