TY - JOUR
T1 - Clinical Pregnancies and Live Births in women approaching ART
T2 - A follow-up analysis of 157 women after thrombophilia screening
AU - Grandone, E.
AU - Villani, M.
AU - Tiscia, G. L.
AU - Dentali, F.
AU - Colaizzo, D.
AU - Cappucci, F.
AU - Chinni, E.
AU - Ageno, W.
AU - Margaglione, M.
PY - 2014/2
Y1 - 2014/2
N2 - 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" "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.
AB - 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" "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.
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U2 - 10.1016/j.thromres.2013.11.016
DO - 10.1016/j.thromres.2013.11.016
M3 - Article
C2 - 24321417
AN - SCOPUS:84892368620
VL - 133
SP - 168
EP - 172
JO - Thrombosis Research
JF - Thrombosis Research
SN - 0049-3848
IS - 2
ER -