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Allam MM, El‐Zawawy HT, Barakat SS, Ahmed SM, Saleh RNM. A hidden cause of infertility in hypothyroid patients. Clin Case Rep 2020; 8:374-378. [PMID: 32128192 PMCID: PMC7044389 DOI: 10.1002/ccr3.2654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/04/2019] [Accepted: 12/14/2019] [Indexed: 12/18/2022] Open
Abstract
Methylene tetrahydrofolate reductase (MTHFR) gene mutations could be the cause of infertility in hypothyroid patients. Hence, it is worthy to screen for MTHFR gene mutations in infertile hypothyroid females and their partners if infertility persists after optimizing thyroid function.
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Affiliation(s)
- Magdy Mohamed Allam
- Internal Medicine Department, Endocrinology UnitAlexandria University Student Hospital (AUSH)AlexandriaEgypt
| | | | - Sherine Samir Barakat
- Internal Medicine DepartmentHaematology UnitAlexandria University Student Hospital (AUSH)AlexandriaEgypt
| | - Soha Magdy Ahmed
- Internal Medicine Department, Endocrinology UnitAlexandria University Student Hospital (AUSH)AlexandriaEgypt
| | - Rasha Noureldin M. Saleh
- Clinical Pathology DepartmentFaculty of MedicineAlexandria UniversityAlexandriaEgypt
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
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Rogenhofer N, Bohlmann MK. Gerinnungsabklärung und Therapie bei habituellen Aborten und wiederholtem Implantationsversagen. GYNAKOLOGISCHE ENDOKRINOLOGIE 2019. [DOI: 10.1007/s10304-019-0261-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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3
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Vlachadis N, Tsamadias V, Vrachnis N, Kaparos G, Vitoratos N, Kouskouni E, Economou E. Associations of combined polymorphisms of the platelet membrane glycoproteins Ia and IIIa and the platelet-endothelial cell adhesion molecule-1 and P-Selectin genes with IVF implantation failures. J OBSTET GYNAECOL 2017; 37:363-369. [PMID: 28388872 DOI: 10.1080/01443615.2016.1256978] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The aim of the study was to investigate the combined impact of the genetic heterogeneity of the glycoproteins Ia (GpIa) and IIIa (GpIIIa) and the platelet-endothelial cell adhesion molecule-1 (PECAM-1) and P-Selectin genes on IVF embryo transfer implantation failures (IVF-ET failures). Sixty nulligravida women with previous IVF-ET failures and 60 fertile controls were genotyped for the GpIa-C807T, GpIIIa-PlA1/PA2, PECAM-1-C373G (Leu125Val) and P-Selectin-A37674C (Thr715Pro) polymorphisms by pyrosequencing. Compared with wild-type combined homozygotes, carriers of combinations of risk alleles in two gene loci were at significantly increased risk for IVF-ET failure, whereas carriers of the combination of GpIa-807T, GpIIIa-PlA2 and PECAM-1-373G alleles had OR = 52.50 (95%CI: 4.05-680.95, p < .001). The area under the receiver-operating characteristic curve (AUC) based on the number of polymorphisms and the number of risk alleles per subject was 75.4% (95%CI: 66.7%-82.8%, p < .001) and 72.5% (95%CI: 63.6%-80.3%, p < .001), respectively. The OR per polymorphism and risk allele increase was 4.26 (95%CI: 2.15-8.41, p < .001) and 2.85 (95%CI: 1.71-4.76, p < .001), respectively. The above associations were more robust among younger women. The combined analysis of these polymorphisms revealed strong association of combined carriers with IVF-ET failures especially for younger women and provided a genetic risk score with good diagnostic accuracy in the prediction of IVF-ET failures.
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Affiliation(s)
- Nikolaos Vlachadis
- a Clinical Laboratory of Therapeutic Individualization, Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Vasileios Tsamadias
- a Clinical Laboratory of Therapeutic Individualization, Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Nikolaos Vrachnis
- b Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Georgios Kaparos
- c Department of Microbiology and Biochemistry , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Nikolaos Vitoratos
- b Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Evaggelia Kouskouni
- a Clinical Laboratory of Therapeutic Individualization, Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece.,c Department of Microbiology and Biochemistry , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
| | - Emmanuel Economou
- a Clinical Laboratory of Therapeutic Individualization, Second Department of Obstetrics and Gynecology , National and Kapodistrian University of Athens, School of Medicine, Aretaieio Hospital , Athens , Greece
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4
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What exactly do we mean by ‘recurrent implantation failure’? A systematic review and opinion. Reprod Biomed Online 2014; 28:409-23. [DOI: 10.1016/j.rbmo.2013.12.006] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/12/2013] [Accepted: 12/12/2013] [Indexed: 11/18/2022]
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Barri PN, Coroleu B, Clua E, Tur R, Boada M, Rodriguez I. Investigations into implantation failure in oocyte-donation recipients. Reprod Biomed Online 2013; 28:99-105. [PMID: 24268727 DOI: 10.1016/j.rbmo.2013.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 07/26/2013] [Accepted: 08/08/2013] [Indexed: 11/18/2022]
Abstract
In recent decades, the Western world has been experiencing a societal trend to prioritize the professional careers of women who postpone motherhood to about 40 years of age, when, unfortunately, natural reproductive potential declines. This is the reason why these women increasingly find it necessary to resort to oocyte donation to have a child. Thanks to the young age of the donors, the efficacy of oocyte donation is the highest of all assisted reproduction treatments and pregnancy rates achieved with this technique exceed 50%. Moreover, the large registries from ESHRE and ASRM show live birth rates close to this figure. However, there are patients who experience repeated failures in several oocyte-donation cycles, and so far oocyte-donation repeated implantation failure has not been clearly defined. This study analysed the results obtained from 2531 oocyte-donation cycles carried out in 1990 patients and defines oocyte-donation repeated implantation failure as failure to implant with more than two embryo transfers and more than four high-grade embryos transferred. This study observed this condition in 140 oocyte recipients (7%). Also, oocyte cohort size, uterine factors and systemic thrombophilias as important aetiological factors were identified were to offer new therapeutic strategies to patients.
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Affiliation(s)
- Pedro N Barri
- Service of Reproductive Medicine, Department of Obstetrics, Gynecology and Reproduction, Hospital Universitario Quirón Dexeus, Càtedra d' Investigació en Obstetricia i Ginecología, Universitat Autònoma de Barcelona, Spain.
| | - Buenaventura Coroleu
- Service of Reproductive Medicine, Department of Obstetrics, Gynecology and Reproduction, Hospital Universitario Quirón Dexeus, Càtedra d' Investigació en Obstetricia i Ginecología, Universitat Autònoma de Barcelona, Spain
| | - Elisabet Clua
- Service of Reproductive Medicine, Department of Obstetrics, Gynecology and Reproduction, Hospital Universitario Quirón Dexeus, Càtedra d' Investigació en Obstetricia i Ginecología, Universitat Autònoma de Barcelona, Spain
| | - Rosa Tur
- Service of Reproductive Medicine, Department of Obstetrics, Gynecology and Reproduction, Hospital Universitario Quirón Dexeus, Càtedra d' Investigació en Obstetricia i Ginecología, Universitat Autònoma de Barcelona, Spain
| | - Montserrat Boada
- Service of Reproductive Medicine, Department of Obstetrics, Gynecology and Reproduction, Hospital Universitario Quirón Dexeus, Càtedra d' Investigació en Obstetricia i Ginecología, Universitat Autònoma de Barcelona, Spain
| | - Ignacio Rodriguez
- Service of Reproductive Medicine, Department of Obstetrics, Gynecology and Reproduction, Hospital Universitario Quirón Dexeus, Càtedra d' Investigació en Obstetricia i Ginecología, Universitat Autònoma de Barcelona, Spain
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Akhtar MA, Sur SD, Raine‐Fenning N, Jayaprakasan K, Thornton JG, Quenby S. Heparin for assisted reproduction. Cochrane Database Syst Rev 2013; 2013:CD009452. [PMID: 23955506 PMCID: PMC10788127 DOI: 10.1002/14651858.cd009452.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Heparin as an adjunct in assisted reproduction (peri-implantation heparin) is given at or after egg collection or at embryo transfer during assisted reproduction. Heparin has been advocated to improve embryo implantation and clinical outcomes. It has been proposed that heparin enhances the intra-uterine environment by improving decidualisation with an associated activation of growth factors and a cytokine expression profile in the endometrium that is favourable to pregnancy. OBJECTIVES To investigate whether the administration of heparin around the time of implantation (peri-implantation heparin) improves clinical outcomes in subfertile women undergoing assisted reproduction. SEARCH METHODS A comprehensive and exhaustive search strategy was developed in consultation with the Trials Search Co-ordinator of the Cochrane Menstrual Disorders and Subfertility Group (MDSG). The strategy was used in an attempt to identify all relevant studies regardless of language or publication status (published, unpublished, in press, and in progress). Relevant trials were identified from both electronic databases and other resources (last search 6 May 2013). SELECTION CRITERIA All randomised controlled trials (RCTs) were included where peri-implantation heparin was given during assisted reproduction. Peri-implantation low molecular weight heparin (LMWH) during IVF/ICSI was given at or after egg collection or at embryo transfer in the included studies. Live birth rate was the primary outcome. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility and quality of trials and extracted relevant data. The quality of the evidence was evaluated using GRADE methods. MAIN RESULTS Three RCTs (involving 386 women) were included in the review.Peri-implantation LMWH administration during assisted reproduction was associated with a significant improvement in live birth rate compared with placebo or no LMWH (odds ratio (OR) 1.77, 95% confidence interval (CI) 1.07 to 2.90, three studies, 386 women, I(2) = 51%, very low quality evidence with high heterogeneity). There was also a significant improvement in the clinical pregnancy rate with use of LMWH (OR 1.61, 95% CI 1.03 to 2.53, three studies, 386 women, I(2) = 29%, very low quality evidence with low heterogeneity).However these findings should be interpreted with extreme caution as they were dependent upon the choice of statistical method: they were no longer statistically significant when a random-effects model was used.Adverse events were poorly reported in all included studies, with no comparative data available. However, LMWH did cause adverse effects including bruising, ecchymosis, bleeding, thrombocytopenia and allergic reactions. It appeared that these adverse effects were increased if heparin therapy was used over a longer duration. AUTHORS' CONCLUSIONS The results of this Cochrane review of three randomised controlled trials with a total of 386 women suggested that peri-implantation LMWH in assisted reproduction treatment (ART) cycles may improve the live birth rate in women undergoing assisted reproduction. However, these results were dependent on small low quality studies with substantial heterogeneity, and were sensitive to the choice of statistical model. There were side effects reported with use of heparin, including bruising and bleeding, and no reliable data on long-term effects. The results do not justify this use of heparin outside well-conducted research trials.These findings need to be further investigated with well-designed, adequately powered, double-blind, randomised, placebo-controlled, multicentre trials. Further investigations could also focus on the effects of the local (uterine) and not systemic application of heparin during ART.
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Affiliation(s)
- Muhammad A Akhtar
- St Mary's HospitalReproductive MedicineHathersage RoadManchesterUKM13 0JH
| | - Shyamaly D Sur
- Queen Charlotte's and Chelsea HospitalImperial College Healthcare TrustLondonUK
| | - Nick Raine‐Fenning
- University of NottinghamDivision of Child Health, Obstetrics and Gynaecology, School of MedicineD Floor, East Block, Queens Medical CentreNottinghamUKNG27SE
| | - Kannamannadiar Jayaprakasan
- University of NottinghamDivision of Child Health, Obstetrics and Gynaecology, School of MedicineD Floor, East Block, Queens Medical CentreNottinghamUKNG27SE
| | - Jim G Thornton
- University of NottinghamDivision of Child Health, Obstetrics and Gynaecology, School of MedicineD Floor, East Block, Queens Medical CentreNottinghamUKNG27SE
| | - Siobhan Quenby
- University of WarwickClinical Sciences Research InstituteCoventryUKCV4 7AL
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Choe SA, Tae JC, Shin MY, Kim HJ, Kim CH, Lee JY, Hwang D, Kim KC, Suh CS, Jee BC. Application of sperm selection using hyaluronic acid binding in intracytoplasmic sperm injection cycles: a sibling oocyte study. J Korean Med Sci 2012; 27:1569-73. [PMID: 23255860 PMCID: PMC3524440 DOI: 10.3346/jkms.2012.27.12.1569] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 10/11/2012] [Indexed: 12/27/2022] Open
Abstract
The purpose of this study was to investigate whether sperm selection by hyaluronic acid (HA) binding could improve fertilization rate and embryo quality in intracytoplasmic sperm injection (ICSI) cycles. Two hundred nineteen oocytes obtained from eighteen women were injected with either HA-bound (n = 107) or conventionally selected spermatozoa (n = 112) in a randomized way. All of the participants were infertile couples who had normal sperm parameters but low fertilization rate in previous in vitro fertilization (IVF) cycle (n = 5) or experienced multiple IVF failures (n = 13). Lower fertilization (75.7% vs 83.0%) and cleavage rate on day 2 (72.9% vs 83.0%) was observed in oocytes injected with HA-bound spermatozoa than the conventional group, but the difference was not significant. Significantly lower cleavage rate was observed on day 3 in HA group (56.0% vs 69.6%, P = 0.038). Blastocyst formation rate and the number of transferred embryos were similar in both groups. In multiple IVF failure patients, significantly reduced fertilization rate (71.8% vs 85.3%, P = 0.046) and cleavage rate on day 2 (70.4% vs 85.3%, P = 0.029) and day 3 (53.5% vs 77.3%, P = 0.002) were noticed in HA group. Five women achieved pregnancy continuing more than 12 weeks after transfer (27.8%). Success of ICSI was not related with the number of embryos fertilized by HA-bound spermatozoa. Application of ICSI by sperm selection using HA binding is not helpful in couples with repeated poor fertilization or implantation despite normal sperm parameters.
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Affiliation(s)
- Seung Ah Choe
- Institute of Fertility and Genetics, Hamchoon Women's Clinic, Seoul, Korea
| | - Jin Chul Tae
- Institute of Fertility and Genetics, Hamchoon Women's Clinic, Seoul, Korea
| | - Mi Young Shin
- Institute of Fertility and Genetics, Hamchoon Women's Clinic, Seoul, Korea
| | - Hyun Jung Kim
- Institute of Fertility and Genetics, Hamchoon Women's Clinic, Seoul, Korea
| | - Chung Hyon Kim
- Institute of Fertility and Genetics, Hamchoon Women's Clinic, Seoul, Korea
| | - Joong Yeup Lee
- Institute of Fertility and Genetics, Hamchoon Women's Clinic, Seoul, Korea
| | - Doyeong Hwang
- Institute of Fertility and Genetics, Hamchoon Women's Clinic, Seoul, Korea
| | - Ki Chul Kim
- Institute of Fertility and Genetics, Hamchoon Women's Clinic, Seoul, Korea
| | - Chang Suk Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
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Shohayeb A, El-Khayat W. Does a single endometrial biopsy regimen (S-EBR) improve ICSI outcome in patients with repeated implantation failure? A randomised controlled trial. Eur J Obstet Gynecol Reprod Biol 2012; 164:176-9. [PMID: 22835632 DOI: 10.1016/j.ejogrb.2012.06.029] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 06/01/2012] [Accepted: 06/27/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate the effect of a single endometrial biopsy regimen (S-EBR) in the cycle preceding the ICSI cycle in patients with repeated implantation failure. STUDY DESIGN This was a prospective randomized controlled trial which included two-hundred infertile women with a history of repeated implantation failure. The subjects were randomly divided into two groups. Group A subjects underwent hysteroscopy and endometrial scraping by Novak curette in the cycle preceding the ICSI cycle, while group B subjects underwent hysteroscopy without endometrial scraping. Implantation rate, clinical pregnancy rate, abortion rate and live birth rate were compared between both groups. RESULTS The number of retrieved oocytes in group A was 11.6 ± 3 and in group B was 11.6 ± 2.8 with no statistically significant difference (p=0.787). There were statistically significant differences regarding the implantation rate, the clinical pregnancy rate and live birth rate. The implantation rate in group A was 12% while in group B it was 7% (p=0.015), the clinical pregnancy rate was 32% in group A while it was only 18% in group B (p=0.034) and the live birth rate was 28% in group A while it was 14% in group B (p=0.024). CONCLUSIONS The single endometrial biopsy regimen (S-EBR) performed during hysteroscopy has statistically significant higher implantation rate, clinical pregnancy rate and live birth rate than hysteroscopy without endometrial scraping.
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Affiliation(s)
- Amal Shohayeb
- IVF Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt; Samir Abbas IVF Center, Jeddah, Saudi Arabia
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Hamdi K, Vaezi M, Dagigazar B, Mehrzad Sadagiani M, Farzadi L, Pashaei-Asl M. Association between Thrombophilia and Repeated Assisted Reproductive Technology Failures. Adv Pharm Bull 2012; 2:233-7. [PMID: 24312798 DOI: 10.5681/apb.2012.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 07/30/2012] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This study was performed to investigate the incidence of thrombophilic gene mutations in repeated assisted reproductive technology (ART) failures. METHODS The prevalence of mutated genes in the patients with a history of three or more previous ART failures was compared with the patients with a history of successful pregnancy following ARTs. The study group included 70 patients, 34 with three or more previously failed ARTs (A) and control group consisted of 36 patients with successful pregnancy following ARTs (B). All patients were tested for the presence of mutated thrombophilic genes including factor V Leiden (FVL), Methylenetetrahydrofolate reductase (MTHFR) and Prothrombin (G20210A) using real-time polymerase chain reaction (RT- PCR). RESULTS Mutation of FVL gene was detected in 5.9% women of group A (2 of 34) compared with 2.8% women (1 of 36) of control group (P = 0.6). Mutation of MTHFR gene was found in 35.3% (12 cases) as compared with 50% (18 cases) of control (35.3% versus 50%; P = 0.23). Regarding Prothrombin, only control group had 5.6% mutation (P = 0.49). No significant differences were detected in the incidences of FVL, Prothrombin and MTHFR in the study group A compared with the control group B. CONCLUSION The obtained results suggest that thrombophilia does not have a significant effect in ART failures.
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Affiliation(s)
- Kobra Hamdi
- Women's Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
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Kuperman A, Di Micco P, Brenner B. Fertility, Infertility and Thrombophilia. WOMENS HEALTH 2011; 7:545-53. [DOI: 10.2217/whe.11.61] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Hypercoagulation has been reported in some studies to be associated with reproductive failures, such as unexplained infertility, IVF implantation failure and recurrent fetal losses. Many pregnancy-related disorders have been interpreted as consequences of impaired microvascular function and might be viewed as a mild form of venous thromboembolic disease. In the absence of clinical guidelines, there is a need for an evidence base regarding thrombophilic screening and antithrombotic therapy in cases of reproductive failure. This article will focus on the controversial effect of congenital and acquired thrombophilia on human fertility, and will review the English literature for relevant studies identified by searching PubMed® results between January 1966–November 2010 using the key words: ‘thrombophilia‘, ‘fertility’ and ‘infertility‘.
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Affiliation(s)
- Amir Kuperman
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion, Efron Street, PO Box 9649, Bat Galim, Haifa 31096, Israel
| | | | - Benjamin Brenner
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion, Efron Street, PO Box 9649, Bat Galim, Haifa 31096, Israel
- Thrombosis & Hemostasis Unit, Rambam Health Care Campus, 6 Ha'Aliya Street, PO Box 9602, Haifa 31096, Israel
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Lodigiani C, Di Micco P, Ferrazzi P, Librè L, Arfuso V, Polatti F, Michela B, Rossini R, Morenghi E, Rota L, Brenner B, Paolo ELS. Low-Molecular-Weight Heparin in Women with Repeated Implantation Failure. WOMENS HEALTH 2011; 7:425-31. [DOI: 10.2217/whe.11.38] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Implantation failure is common in assisted reproduction techniques (ART). The role of low-molecular-weight heparin (LMWH) is a matter of debate as a potential factor to improve implantation. Aim: To evaluate the pregnancy rate in patients with or without heparin administration. Materials & methods: We performed a retrospective observational analysis of patients with at least two IVF/intracytoplasmic sperm injection cycles with implantation failure, screened for inherited thrombophilia and submitted to further ART cycles with or without administration of LMWH. A total of 265 patients fulfilled the enrollment criteria. Of these 149 (56%) were primary infertile and 116 (44%) were secondary infertile. Their mean age was 36.3 ± 3.6 years. We analyzed basal FSH, smoking habit, gene variants for inherited thrombophilia (i.e., MTHFR C677T, prothrombin G202A10G and factor V Leiden). The patients underwent 569 new ART cycles: 512 (90%) without and 57 (10%) with LMWH. Results: In total 105 clinical pregnancies were observed in 569 cycles (18.8%). The pregnancy rate was 17.19% (88/512) in patients not treated with LMWH and 29.52% (17/57) in the LMWH-treated group (p = 0.006). In women over 36 years of age the pregnancy rate was 15.53% (50/322) in nontreated versus 35.71% (10/28) in treated cycles (p = 0.007), while no difference was found in younger women. No statistical difference was found between the presence of inherited thrombophilia and pregnancy rate in treated and untreated cycles. Discussion: significantly higher pregnancy rate in patients with previous ART implantation failures was observed with LMWH. Our results confirm no relation among inherited thrombophilia and pregnancy rate in patients with previous IVF implantation failures. These findings should be confirmed by randomized controlled trials before use of LMWH for ART cycles is recommended.
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Affiliation(s)
| | - Pierpaolo Di Micco
- Thrombosis Center, IRCCS Istituto Clinico Humanitas, Milan, Italy
- Emergency Room, Division of Medicine, Fatebenefratelli Hospital of Naples, Italy
| | - Paola Ferrazzi
- Thrombosis Center, IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Luca Librè
- Thrombosis Center, IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Veronica Arfuso
- Department Gynaecology & Reproductive Medicine, IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Franco Polatti
- Centro di Ricerca Procreazione Medicalmente Assistita, Fondazione Policlinico San Matteo, Dipartimento scienze morfologiche eidologiche e cliniche, Università degli Studi di Pavia, Pavia, Italy
| | - Benigna Michela
- Centro di Ricerca Procreazione Medicalmente Assistita, Fondazione Policlinico San Matteo, Dipartimento scienze morfologiche eidologiche e cliniche, Università degli Studi di Pavia, Pavia, Italy
| | - Roberta Rossini
- Centro di Ricerca Procreazione Medicalmente Assistita, Fondazione Policlinico San Matteo, Dipartimento scienze morfologiche eidologiche e cliniche, Università degli Studi di Pavia, Pavia, Italy
| | | | - Lidia Rota
- Thrombosis Center, IRCCS Istituto Clinico Humanitas, Milan, Italy
| | - Benjamin Brenner
- Thrombosis & Hemostasis Unit, Rambam Health Care Campus, Technion, Israel Institute of Technology, Haifa, Israel
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12
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Effects and effectiveness of heparin in assisted reproduction. J Reprod Immunol 2011; 90:82-90. [DOI: 10.1016/j.jri.2011.03.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 03/08/2011] [Accepted: 03/15/2011] [Indexed: 12/20/2022]
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13
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Nelson SM. Is placental haemostasis relevant to recurrent implantation failure? Thromb Res 2011; 127 Suppl 3:S93-5. [PMID: 21262453 DOI: 10.1016/s0049-3848(11)70025-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Scott M Nelson
- Centre for Population and Health Sciences, University of Glasgow, UK.
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